The status quo of super-large hospitals and the reasons for their emergence With a large population base and a large number of doctors, the Zhengda First Affiliated Hospital has a daily outpatient volume of 20,000. There are currently 7,000 beds, more than 350,000 inpatients a year, and more than 200,000 operations. At the same time, because 75% of the patients are rural hukou, Zhengda First Affiliated Hospital has the title of “the largest township hospital in the worldâ€. Although compared with many hospitals of the same level in China, the per capita hospitalization cost of Zhengda First Affiliated Hospital is 1,500-2,000 yuan lower. However, in 2015, the hospital announced that it achieved a revenue of 7.521 billion yuan in 2014, and recently held the 2015 annual summary meeting. In 2015, the hospital's revenue was 8.409 billion yuan, a year-on-year increase of 11.8% in 2014, still causing many people's Non-consideration. Under the grading diagnosis and treatment policy, is the existence of a super-large hospital a meritorious service? In these years, the hospital will become bigger and stronger, build a national-level regional medical center, improve medical conditions and environment, and enable more people to have local medical treatment. It has become a common problem in the expansion of large hospitals and the national medical system. At the same time, China's medical reform has pushed medical care into the market, but in the process, it has not formed a standardized market competition mechanism. The graded diagnosis and treatment system before the medical reform was broken, and the hospitals of different colors were placed in the same basket to compete freely. . In such a competition system, the polarization of the strong, strong and strong Matthew effect will inevitably lead to the emergence of medical oligarchs. In fact, behind these “famous hospitals†and “big courtyards†across the country continue to grow bigger and stronger, many small and medium-sized hospitals are struggling in the torrent of reforms and are shrinking. More patients are passively rushing to large hospitals, and the more large hospitals are expanding but the more tight the beds have become a vicious circle. It is precisely because of this realization that to break this medical oligopoly situation, the state solemnly proposes to implement a grading diagnosis and treatment policy nationwide, and to include this policy in the 13th Five-Year Plan to curb urban tertiary hospitals. The expansion of the monomer, reducing the number of outpatients, diverting patients with chronic diseases, and reducing their average hospitalization days to a minimum. But unfortunately, there are policies and countermeasures. These “super large hospitals†that have a dominant position in the history of expansion often get the most protection. Take Zhengdayi Affiliated Hospital as an example, the general trend of grading diagnosis and treatment policies. Next, public reports show that the Zhengda First Affiliated Hospital, in the form of counterpart support, medical association support, etc., in order to ensure that the future "severe illness does not leave the county", can continue to upload patients, has already included a number of vice presidents The backbone of the school is sent to the county hospital as the dean. What role does the medical association play in grading diagnosis and treatment? As a new thing in the hospital's response to the grading diagnosis and treatment policy, the medical association is simply to draw experts from large hospitals and regularly go to the grassroots community hospitals for treatment. In case of serious illness, they will enjoy the green channel of optimization and inspection in the “medical associationâ€. Go directly to the counterpart's top three hospitals. Compared with the past, shorten the time for visiting and checking. In fact, the good intentions of the upper level can be seen, but once it reaches the grassroots level, it becomes a good name. The main reason is the game of interest. In the current environment, the pattern of running a doctor has influenced the development of the medical association. Hospitals at all levels are responsible for their own profits and losses, each with their own interests, and the balance is based only on the distribution of benefits. From the perspective of the overall layout of medical resources in China, the problem of uneven distribution of resources in the medical field is the most serious. Focusing on the distribution of benefits, integrating medical resources in the same region, and implementing resource sharing, the tertiary hospitals in the same region are grouped with secondary hospitals, community hospitals, and village hospitals. Such a “medical association†is not a solution. The essential. The primary medical institutions will not receive substantial reforms. The final result is that the patient diversion is not ideal. The first visit is difficult to flow to the grassroots. The two-way referral “upward referral†is the driving force, and the “downward referral†is the resistance. At the same time, if this degree is not well grasped, the medical association may eventually become a siphon, siphoning patients, even doctors and nurses into large hospitals, and completely turning into "there is no long grass under the big tree." In short, under the general situation of implementing graded diagnosis and treatment, how will the super-large hospital become in the future, and how the medical association can help to classify the diagnosis and treatment in the future, whether it is too much or not, depends on the large pattern of medical treatment in the whole country.
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