Abstract
In the study of the sustainable development of public health in China, academic circles have little to do with the unique hierarchical medical system and online appointment diagnosis system in China’s medical system. Therefore, based on the medical situation in Shanghai, China, in addition to the traditional dimension of medical expenses, this paper fully considers the impact of the current hierarchical medical policy, constructs a selection model for medical treatment behavior under the hierarchical medical system and online appointment diagnosis system, and carries out simulation analysis through the cellular automata grid dynamic model. This paper finds that the time-cost-oriented medical treatment behavior of Chinese patients will have different distribution under the current hierarchical medical system and online appointment diagnosis system. (1) When the medical treatment system neither allows online appointment nor referral, a large number of patients congregated in high-grade hospitals, with the most unreasonable distribution. (2) With the implementation of the system of allowing referral and online appointment, patients are gradually diverted to lower-grade hospitals or off-peak hours, and the distribution is relatively improved. (3) If the medical treatment system allows both referral and online appointment, the distribution of patients is the most reasonable. Therefore, China’s current hierarchical medical system and online appointment diagnosis system will, to a considerable extent, become a policy tool that affects patients’ choice of hospitals and an effective means to achieve the rational allocation of existing medical resources, which will play an important role in the sustainable development of public health in China.
Highlights
In 2018, the total number of instances of people using medical and health institutions in China has reached 8.31 billion, an increase of 130 million over the previous year [1], which has put great pressure on medical institutions
In order to improve the level of medical treatment and promote the sustainable development of public health, the State Council further deepened the reform of the medical and health system implemented since 2009 and improved the hierarchical medical system and online appointment diagnosis system [2,3,4]
This article will cover the cells of the Shanghai medical system coverage area, that is, 1/6 of the service area of a single superior medical institution is divided into 465 cells, of which 435 are diamonds and 30 are triangles
Summary
In 2018, the total number of instances of people using medical and health institutions in China has reached 8.31 billion, an increase of 130 million over the previous year [1], which has put great pressure on medical institutions. 2009, the Ministry of Health issued its opinions on the implementation of appointment diagnosis and treatment services in public hospitals, which requires all public hospitals to fully implement appointment diagnosis policy and vigorously build the online appointment diagnosis and real-name appointment system of hospitals at all levels [19] These measures are helpful to alleviate the pressure of medical treatment, cooperate with the hierarchical medical system, and promote the sustainable development of public health [20,21,22,23]. Based on the above analysis and the policy simulation of the medical situation in Shanghai, this paper depicts the impact of hierarchical medical and online appointment diagnosis policies on patients’ choice of medical treatment and gives corresponding suggestions for using the above policies to better promote the future sustainable development of public health in China
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