The Changning model in the exploration and reform of Chinese family doctor system / 中国卫生政策研究

Exploring the Chinese family doctor system is an important policy issue in the process of deepening the medical and health care system reform in China. Changning District is the first comprehensive reform pilot area of community health service in the country,and the first demonstration area to explore the family doctor system reform. Since 2008,Changning began to gradually explore the family doctor system, and it has accumulated a lot of experi-ences which can be copied and extended in signing services to improve the family doctor,the full establish a compre-hensive system of hierarchical diagnosis and treatment system,the formation of the reasonable medical order that first primary diagnosis,two-way referral,upper and lower linkage,acute and chronic treatment. The four articles of this topic are from a survey from 10th anniversary of the comprehensive reform of the family doctor system in Changning District,Respectively from the service model,government coordination,performance appraisal and continuing educa-tion,to demonstrate the effectiveness of the policy and practice of the comprehensive reform about family doctor sys-tem in Changning District. With the implementation of the family doctor service on-site promotion meeting, the Changning model of Chinese family doctor system will provide valuable experience to explore and deepen the reform of the family doctor system.

The model and version upgrade of community health care reform:A case study of Changning District of Shanghai / 中国卫生政策研究

Any reform needs to be converted into a series of institutional arrangements or micro behavior incen-tive mechanism,not only to ensure basic behavioral strategies of incentive compatibility between actors are motivated, but also to ensure that the behavior mode of grass-roots actors and policy direction are consistent. From the practice of community health reform of Changning District of Shanghai,it has generally gone through four stages:standardization construction and organization establishment,service model and mechanism reform, incentive mechanism design and connotation construction,platform build and performance improvement. Changning medical reform in the continuous deepening of policy trials and solve all kinds of new problems in the new medical reform policy implementation gener-ated by the process of policy and system innovation in the test(such as doctors weakened incentive problems after two lines of revenue and expenditure) and its compatibility with the environment problem. In order to realize the system of health care policy and provide stable behavioral expectations for the stakeholders to improve the welfare of stake-holders thereby continuously reducing the potential resistance to the implementation of the policy of grass-roots actors, and gradually guide the behavior of various actors to guide the direction consistent with the policy objectives

The government collaboration and medical insurance to boost:"The Four medical linkage"under the protection of family doctor service / 中国卫生政策研究

The government coordinated governance is the necessary support and important direction of China's medical reform. During the development process of the family doctor system in Changning District of Shanghai, the coordinated governance of health, medical insurance, civil affairs, finance and other departments for the difficulties of the crowd, through"the four medical linkage"basic medical security health collaborative governance by the"basic medical insurance+basic medical services+government medical assistance+social or-ganization medical help"for the poor people, made the system realize the sustainable development of incentive compatibility. The ten years of reform and policy practice shows that to precisely determine the service population by the Health and Family planning Commission and Civil Affairs Bureau,the policy coordination to pay the fami-ly doctors contract service fee by health insurance and Finance Bureau, the medical resources integration support by community family doctor studio, Community health construction and sharing constitute the developing direc-tion of family doctor service model in China.