Beijing, 3 Mar (Zhongxin Net) -- During the National People's Congress and the National People's Congress and the National People's Congress this year, a doctor named "Zhang Fei" caught fire. Zhang Wenhong, a member of the National Committee of the Chinese People's Political Consultative Conference and a professor at Huashan Hospital of the National Center for Infectious Diseases, described as a doctor with a "brave name" is actually a representative of many grassroots doctors.

After the steady turn of epidemic prevention and control, since the beginning of this year, both the National Two Sessions and the Provincial Two Sessions have specifically mentioned promoting the construction of primary medical care. Why is primary care important? What are the difficulties and dilemmas in the current development of community healthcare?

Infographic: A healthcare worker dispensing medicine. Photo by Liu Lixin

What can a "hospital on your doorstep" do?

Community medical and health services are primary health services integrating prevention, health care, rehabilitation and health education. Community health service centers are considered to be "hospitals on the doorstep", mainly meeting the needs of surrounding residents for nearby medical treatment and dispensing medicines.

Liu Yuanli, Executive Dean of the School of Health Management Policy of the Chinese Academy of Medical Sciences/Peking Union Medical College and Distinguished Professor of Health Policy and Management, told Chinanews.com that the professional foundation of primary medical and health services is "general medicine".

"This 'whole' is manifested in three aspects: the mastery of the comprehensive situation of the service recipients, the comprehensive and healthy management, and the coordination of the whole service. Compared with hospitals, this is also the characteristics and comparative advantages of community medical care. Liu Yuanli said.

Li Jing, 34, is a doctor at a community health service center in Tianjin. She told Chinanews.com that most of the people who come to the community for medical treatment are the elderly and patients with chronic diseases such as diabetes and hypertension, and doctors are mainly responsible for outpatient clinics, prescription of drugs and medical security for some community activities.

"Experienced doctors can see 50 to 100 patients a day. The relationship between doctors and patients is also very close, and some doctors will have their own fixed patients, or patients will identify this doctor to see him. Li Jing said that patients often come to see her with fruits and snacks. When the clinic is not busy, some elderly patients will come to sit.

"Maybe some elderly people feel that community doctors are more cordial, have rich consultation time, and say more about their condition, body and family situation." Although Li Jing is young, she is very willing to talk to these patients more, "I will often tell them a few more words on how to take medicine, or help them see which drugs are cost-effective and effective."

Li Jing recalled that a patient she met in the past not only trusted her very much, often consulted her, but also made a large bowl of cool powder waiting for her to leave work. Li Jing wanted to resign, but the patient quickly said: "It's okay, I'm waiting for you at the intersection where you pass after work, I won't leave if you don't come." ”

"It's about comparing hearts to hearts." Li Jing said.

Infographic: The picture shows several nurses exchanging patients' conditions. Photo by Liu Lixin

Why did the Representative propose to change its name to "Community Hospital"?

At the 2023 Shanghai Two Sessions, Jin Ying, a deputy to the Shanghai Municipal People's Congress and director of the Dapuqiao Street Community Health Service Center in Huangpu District, suggested that the "community health service center" be renamed a "community hospital".

Jin Ying once told the media that although the capacity of community health service centers has been continuously enhanced, there are also some problems. For example, for a long time, community health service centers have undertaken more services such as chronic disease management, maternity, child management, and vaccination, and their medical functions are weak. Due to various reasons, the grassroots health talent team is relatively weak, and the residents' intention to receive the first diagnosis at the grassroots level is also low.

In this regard, Hu Xiaoxiang, vice president of the Jiangsu Health Law Society, explained to Chinanews.com that most of the community health service institutions are transformed from the original township health centers and district and county hospitals, and the primary medical capacity is very strong. "Previously, some primary medical institutions could undertake some medical projects such as surgery. Later, in response to the reform of the medical and health system and the promotion of 'equalization of basic public health', primary medical care focused on public health services. ”

It is reported that in 2009, China launched a new round of comprehensive reform of the medical and health system, and the gradual equalization of basic public health services is one of the five key policies in this round of medical reform.

The basic public health program is defined by the State as the minimum package of services that must be provided to the entire population, which does not cover medical services, but only preventive and health management services.

Liu Yuanli told Chinanews.com that the national basic public health service project is aimed at the rapid increase in the incidence of chronic diseases and the long-term lack of attention to disease prevention, so the focus is on "strong prevention" and "strong grassroots".

Jin Ying believes that the proposal to change the name of community health service centers to community hospitals is not just to simply add a brand, but to enhance medical service capacity as a starting point, strengthen comprehensive health management, and eventually allow residents to enjoy a higher level of medical and health services at their doorstep.

Data map: The picture shows two emergency department doctors participating in remote consultation in the ICU conference room. Photo by Liu Lixin

Medicines, equipment, talents...

Strengthen community medical construction, how to do it?

Today, residents are in demand for convenient medical services, and communities have an incentive to upgrade medical technology. Hu Xiaoxiang pointed out that the reform of community primary medical care should be further promoted, some regional financial compensation policies should be implemented, and the development of grassroots medical teams in terms of talents, wards and equipment should be supported.

"In the construction of the talent team, we should also pay attention to the phenomenon of regional siphoning, avoid the emergence of 'peacock flying southeast', and take a variety of measures to continuously attract and enrich grassroots medical talents." Hu Xiaoxiang said.

Liu Yuanli believes that to strengthen the construction of community medical care and realize the development of people-oriented community medical care, there are currently two main tasks: one is to make up for shortcomings and strong and weak items, and the other is to inventory resources and revitalize the market.

He pointed out that China's remote rural areas, urban-rural areas, and emerging urban functional communities relatively lack the effective coverage of the primary health care service network, and the elderly, the disabled, sub-health and sick people need to pay attention to.

Therefore, he believes that under the conditions of market economy, the government can directly provide the "basic" medical and health services they need to people who need help but lack purchasing power, and innovate service methods, such as "mobile diagnosis and treatment centers" and telemedicine to effectively cover remote mountainous areas and urban-rural areas.

Li Jing said that at present, community residents have a large demand for medicine and medication, and it is necessary to increase the types of drugs and diversified medical equipment and equipment, "so that patients can receive good treatment at their doorstep, truly let the primary medical care grow, and do community medical services." (At the request of interviewees, some names in the article are pseudonyms) (End)