What other services can Shanghai’s first community hospital provide? It is the first in the country to connect with commercial insurance
Last month, the first community hospital was born in Shanghai, and the Dapuqiao Community Health Service Center in Huangpu District became a community hospital. More than a month after the first community hospital was launched, some innovative measures have gradually been implemented. Just recently, Dapuqiao Community Hospital successfully connected with commercial health insurance, thus becoming the first community medical institution in the country to connect with commercial insurance.
After being upgraded to a community hospital, Dapuqiao Community Hospital will provide basic medical care. What other services can it provide to residents? What complementary services attract commercial insurance companies to expand into communities? What are the differences between community hospitals and community health service centers? Jiefang Daily·Shangguan News reporter recently conducted an in-depth interview on this.
Make up for the shortcomings of the department and "cover" more common diseases
Shanghai has consolidated its grassroots community health service network. In recent years, 248 community health service centers have been built, and Dapuqiao Community Health Service Center is one of them. On May 13, this "small but beautiful" center announced its second title - Dapuqiao Community Hospital, thus becoming the first community hospital in Shanghai.
What is the difference between a community hospital and a community health service center? The reporter looked at a document issued by the National Health Commission in 2019, which mentioned: The significance of launching a pilot project for the construction of community hospitals is a powerful starting point to improve the ability of grassroots medical and health services, a major measure to promote the construction of a hierarchical diagnosis and treatment system, and an important step to promote the construction of high-quality The inherent requirements of an efficient medical and health service system.
When it comes to building community hospitals, there are three main tasks: to make up for shortcomings and improve the setup of clinical departments and equipment; to seize key points and improve basic medical service capabilities; to deepen reforms and improve the comprehensive service level of the jurisdiction.
Five years after the publication of the article, Shanghai's first community hospital was born based on "slow work and careful work". What shortcomings has Dapuqiao Community Hospital made up for? "From the once large-scale general practice to now more subdivided departments, we strive to solve minor ailments for residents at their doorsteps." Jin Ying, director of Dapuqiao Community Hospital, said bluntly.
Minor surgeries under local anesthesia were once a gap in community diagnosis and treatment, but now they have become one of the most popular projects for residents. Dr. Tian Taoran, who jumped from a higher-level hospital to Dapuqiao Community Hospital, now sees patients in the surgical clinic five days a week and performs surgeries every Wednesday afternoon, including the removal of superficial tumors, mole removal, minimally invasive treatment of underarm odor... In the past, residents had to go to large hospitals to get minor surgeries, but now they can be easily done in the community.
Resident Aunt Qin benefited deeply from this. Aunt Qin's right calf was crushed by a battery car and the skin was slightly damaged. She went to a large hospital to take an X-ray to rule out the fracture and then went home on her own. Unexpectedly, starting on the third day, her calf became bruised and swollen, and a large number of blisters appeared on the skin around the wound. She came to the surgical outpatient clinic of Dapuqiao Community Hospital. Dr. Tian explained: This is a typical severe crush injury. If not treated in time, there is a risk of "compartment syndrome". In severe cases, amputation may even be required.
Dr. Tian formulated a comprehensive treatment plan for Aunt Qin, including thorough debridement, dissolving scabs as soon as possible, changing dressings from time to time, strengthening anti-infection, and reducing swelling... After three weeks of hard work, Aunt Qin's bruised and infected lower limbs improved significantly. Statistics from community hospitals show that there are currently an average of more than 30 outpatient surgeries per day. Since the opening of the outpatient clinic, more than 2,500 cases of debridement and suturing, various dressing changes, and more than 300 surgeries have been completed.
Within three kilometers of Dapuqiao Community Hospital, there are several tertiary hospitals such as Zhongshan, Ruijin, and Ninth Hospital. The geographical location is not advantageous. How to let the 55,300 permanent residents in the jurisdiction "vote with their feet" to choose their home, really needs to take action. A lot of thinking.
The latest outpatient data shows that the hospital currently maintains a daily outpatient volume of 1,200 people, and the highest single-day outpatient volume can reach 1,600. Aunt Liu, a resident, expressed the common sentiment of many people, "Although you can take a taxi to a big hospital, I am happy to come here to see a doctor. The doctors are good and the environment is considerate and comfortable!"
One of the main tasks of benchmarking community hospitals is to improve basic medical services. What problems can be seen in the first community hospital? The reporter found that in addition to the traditional general practice and internal medicine, rehabilitation, traditional Chinese medicine, stomatology, dermatology, etc. are also popular among residents. Since the Spring Festival this year, Dapuqiao Community Hospital has successively opened osteoporosis clinics, weight loss clinics, postpartum rehabilitation exercise clinics, TCM temporomandibular joint disease clinics, and integrated medical and prevention clinics based on the needs of the people... these special clinics , The establishment of subdivided specialized disease outpatient clinics greatly meets the individual needs of residents.
In terms of service hours, community hospitals also have outstanding advantages. The reporter learned that in order to provide residents with full life cycle health services "from embryo to death", the hospital has opened "887" extended services since November last year, including community noon extended outpatient clinics, night outpatient clinics and weekend outpatient clinics. Ensure that medical services are open seven days a week and protect the health of residents in real time.
In the rehabilitation clinic of Dapuqiao Community Hospital, there is almost no rest from morning to night. The reporter walked into the rehabilitation ward of the center, where advanced rehabilitation equipment such as upper and lower limb robots, sky rails, and speech cognitive assessment and training are all available. Since the hospital invited Xie Dangang, director of the Rehabilitation Department of Ruijin Hospital, as the chief rehabilitation consultant, and established a medical alliance with many large hospitals to solidify its rehabilitation skills, this place has become a "big classroom" for elderly rehabilitation patients such as stroke every day during the day.
At night, the rehabilitation department is still booming, and the number of people it serves changes from the elderly to young people. It turns out that after Dapuqiao Community Hospital opened a weight loss clinic at the beginning of the year, many young people came to check in. Rehabilitation therapists Ge Mingjie and Zhang Yang told reporters that the trend of weight loss through exercise is quite popular among young people, and the demand for exercise guidance, exercise prescription, and sports injury rehabilitation treatment is also "rising."
Mr. Liu, a white-collar worker, works nearby. When he learned that the community hospital had opened a weight loss clinic, he came to "check in" as soon as possible. Ge Mingjie customized an "exercise prescription" for Mr. Liu, which included core and shoulder girdle stabilization training, as well as deadlifts, power presses, and silent squats to develop the whole body, combined with 20 minutes of aerobic exercise to achieve the best results. Weight loss effect.
Feng Yuanyuan, chief of the Rehabilitation Department, said that sports injuries such as knee and ankle injuries and tennis elbow are gradually increasing. The department has established cooperation with the Sports Rehabilitation Department of Huashan Hospital to expand service content and conduct regular training to further meet the needs of more people.
In the "task list" of deepening medical reform, what else can Shanghai's first community hospital do? Just last November, Jin Ying, a representative of the Shanghai Municipal People's Congress, proposed the "Recommendations on Incorporating Commercial Health Insurance into Community Medical Institutions." Can commercial insurance "break the ice" and test the community? This pioneering proposal has come to fruition in less than a year.
On May 23, PICC Shanghai Branch launched the "Shanghai Insurance" product, innovatively using Dapuqiao Community Hospital as the designated medical institution for nursing service insurance products, achieving upgrading and innovation in the service model, and thus starting a "first of its kind" in related fields across the country. .
Gu Chunsheng, deputy general manager of PICC Shanghai Branch, told reporters that designated hospitals set up by traditional commercial insurance are usually second- and third-level public hospitals, and community hospitals are first-level hospitals. In addition to basic medical services, what else can be supplemented? Since the end of last year, the company has visited Dapuqiao Community Hospital several times for in-depth research and learned about the service characteristics of this community hospital. "Dapuqiao Community Hospital has 100 beds and has a very good reputation among residents. It has also built a community care center. We closely integrated its inpatient care services and home care services to carefully design insurance products. After multiple rounds of communication, optimization and improvement, we finally Create an insurance product that has broad coverage, benefits residents, and is highly replicable.”
According to reports, this "Shanghai Insurance" product extends downwards in terms of the insurance age. The product specifically sets two insurance liabilities: hospitalization care insurance for specific diseases and home care insurance for specific diseases. The insured can choose nursing services according to their own needs. or cash payment.
"The products mainly focus on exporting nursing services to solve the current situation of scarcity of social nursing services in the aging and declining birthrate. Home care can be an effective supplement to long-term care insurance. For inpatient care, the insured is treated at Dapuqiao Community Hospital You can also enjoy it during the period,” explained the relevant person in charge of PICC Shanghai Branch.
The reporter learned that the cooperation between Ping An Insurance and Dapuqiao Community Hospital is also continuing to advance. Ping An Insurance has launched the "Ping An e-Life Insurance" product and is applying to be included in the product list of the Shanghai Insurance Code medical insurance personal account area. After approval in the future, residents who are hospitalized in Dapuqiao Community Hospital will also be able to make claims and reimbursement under the policy liability. In addition, many insurance companies such as Life Insurance and AIA also went to investigate and discuss cooperation models.
As a pilot unit for high-quality development of community health service centers, Dapuqiao Community Hospital has completed the construction of the "three centers" of the community. Jin Ying said that combined with the "three centers", we will explore the space for commercial insurance to be integrated into community medical care. In the future, for people with chronic diseases, the community Hospitals can also work together to design service packages and subsequently carry out explorations such as "prevention, screening, diagnosis, treatment, and rehabilitation" to provide residents with more personalized health protection.
