The "Decision" points out: "Accelerate the construction of a tiered diagnosis and treatment system." Graded diagnosis and treatment are classified according to the priorities of the disease and the difficulty of treatment. Medical and health institutions of different levels undertake the treatment of different diseases to form a reasonable medical treatment and diagnosis and treatment pattern. The tiered diagnosis and treatment system is an institutional arrangement formed around achieving this goal. Its core can be summarized as primary diagnosis, two-way referral, acute and chronic treatment, and upper and lower linkage. International research believes that about 80% of diseases can be effectively dealt with through primary health care. Building a tiered diagnosis and treatment system is to allow the public to receive diagnosis and treatment of common and frequently occurring diseases in grassroots medical and health institutions nearby, and receive relevant preventive and healthy rehabilitation services; when the disease exceeds the basic diagnosis and treatment capabilities, it is timely referred to the superior medical and health institutions; if the condition is relieved and stable, it is necessary to continue treatment and rehabilitation, then it will be transferred back to the grassroots for treatment and rehabilitation, so that the public can obtain the services they need at their doorstep.
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Although the construction of a tiered diagnosis and treatment system has made positive progress and significant results in our country, there is still a big gap between the deployment requirements of the Party Central Committee and the expectations of the people. The next five years are a critical period for accelerating the construction of a tiered diagnosis and treatment system, and we must accelerate construction with greater determination and greater efforts. We must focus on the tiered diagnosis and treatment goals proposed by General Secretary Xi Jinping, conscientiously implement the deployment of the "Decision" and concentrate our efforts to make breakthroughs in the following aspects. First, focus on talent team building and strengthen the bottom of urban and rural grassroots medical and health service network. Increase efforts to train general practitioners, steadily expand the scale of targeted free medical students in rural orders, improve the incentive mechanism for the use of grassroots medical and health talents, improve policies such as salary, staffing, and professional titles, implement the guarantee work for the preparation of special plans for college students' rural doctors, effectively improve the attractiveness of grassroots medical and health positions, strengthen the high-quality grassroots talent team, and continuously improve the grassroots disease prevention, treatment and health service capabilities. Second, focus on resource sinking and improve the long-term mechanism for urban medical and health resources to support and assist grassroots units. In accordance with the principle of "coordination layout and zoning and area collection", deepen the work of urban tertiary hospitals to support county-level hospitals, organize urban tertiary hospitals to support community health service centers, promote county-level hospitals to support township health centers and village clinics, establish a grassroots medical system, and promote the downward and sharing of talents, technology, and services. Promote telemedicine and medical intelligent auxiliary diagnosis systems to help high-quality medical resources extend to rural areas and grassroots levels. Third, focus on close-knit medical communities and strengthen collaborative services and unified management. Comprehensively promote the construction of close-knit county-level medical communities, explore and promote close-knit urban medical groups, form a community of responsibilities, management, services and interests that closely combine people, finance and materials, and promote resource sharing, institutional linkage, information exchange, and service connection. Taking key diseases as the starting point, we provide residents with integrated and continuous medical and health services such as prevention, diagnosis, treatment, rehabilitation, and nursing. Fourth, focus on implementing functional positioning and promote the expansion and balanced layout of high-quality medical resources. Promote the construction of national medical centers and national regional medical centers in an orderly manner, give full play to the radiation and driving role of provincial high-level hospitals, and further reduce cross-provincial and cross-regional medical treatment. Strengthen the construction of specialized departments of municipal-level hospitals and give full play to the role of the main force in medical treatment. Deeply implement the county-level hospital capacity improvement project, highlight its leading position in the county, build a number of key central health centers, and further increase the medical treatment rate within the county of rural residents. Fifth, focus on guiding the reasonable flow of medical resources and patients, and promote the reform of medical insurance payment and price mechanisms. Give full play to the leverage guiding role of price and medical insurance reimbursement policies on public medical treatment, gradually increase the proportion of services provided by primary medical and health institutions in the total amount of medical services and medical insurance fund payment, and promote the accelerated construction of a tiered diagnosis and treatment system.
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