Study on the Operating Mechanism of Dual Referral System of Community Health Service

Abstract: Research background: Developing dual referral of community health is the result of the change of medical mode and development of medical specialization. To solve series of problems such as unreasonable allocation of health resources, patient’s difficulty of seeing a doctor as a result of high medical cost and rapidly increase health expense, central government has issued series of documents encouraging the development of dual referral of community health. On the basis of such enviroment, dual referral has become hot research field in recent ten years. Combining with its present research status, this text points out its drawbacks, such as it lacks systematic analysis on Chinse macro-health enviroment, lacks of analysis of each body. Given this, this paper explores community helath dual-referral mechanism on the basis of investigation of Fujian community health centers on the topics of their present status of dual referral, their willingness to develop commnity helath dual-referral service and the main factors that influence its development.Through analysing the inflow mechanism and referral mechanism, the paper comes up with relative suggestions for government promoting the development of community health dual referral.Object and Content: The research includes:investigation reasearch and literature research. The investigation focuses on leaders’face-to-face interview and questionnaire investigation for the staff.of the commnity health centers.The investigation areas cover 15 community health centers of Xiamen, Fuzhou, Quanzhou and Longyan.The content of the investigation focuses on their understanding of dual referral, their willingness to develop dual referral, the main factors influencing its development, the suggestions for promoting its development,the research of inflow and referral mechanism. Besides,this paper also introduces British community heath referral platform system. Methods: Researches as literature research, qualitative research, quantitive research, case research and comparative reasearch are applied in this paper.Conclusion:1 The smooth operation of dual referral system of community health service lacks of internal and external conditions. The internal resistance force is the inadequate development of community health agencies and lacks reasonable position for both hospitals and communith health agencies.While the external factors are that China lacks good macro-health enviroment,lacks of motivation and restriction for both hosptials and community health agencies and lacks of shared health information system.2. We should strengthen the control of“person”in the process of dual referral. Such kind of person include patients, GP and doctors. While currently we lack of favorable measures, such as government policy; Insurance strength hasn’t formed into effective control. In this sense, we should improve our health insurance system and strengthen its role in health field. We should take the government policy and health insurance as sthe baton in dual referral system.3. The building of dual referral relys on the prosperity of community health agencies. While the most influential factor is human resources, which include both excellent leaders and staff. The development of community health agencies is the foundation of city health and the basis of the dual referral. The great difference among different levels of health agecies and lack of reasonable position of different levels of medical institutions fail their good interaction. The big hospitals are still prominent in the health field. Therefore the building of dual referral service mechanism relys on the development of community health agencies and reasonable position of different levels of medical institutions…
Key words: Community Health Service; Dual Referral; Referral Mechanism Medical Insurance ; Information Sharing

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