There is a kind of patient outflow called convenient transportation, Shanghai is too strong!
The author | Chaoyang
Source | look at the Jian Yangtze River Delta
Which province do patients prefer to see a doctor in a different place? The first thing that many people may think of is Hebei and Anhui.
However, "official data" shows that the Yangtze River Delta occupies three seats in the five provinces with the largest number of outflow patients in China.
The "Circular of the General Office of the National Health Commission on the Performance Appraisal of National Tertiary Public Hospitals in 2019" shows that the "Package Mail Zone" in Jiangsu, Zhejiang and Anhui are all provinces with large patient outflows.
Patient satisfaction is the highest, and the incidence of off-site medical treatment is still high
The outflow of large provinces is also the inflow of large provinces
People from all over the country come to the "package mail area" to see a doctor
In 2019, the satisfaction of outpatients and inpatients in tertiary public hospitals nationwide was 85.41 points and 91.01 points, respectively, an increase of 1.41 points and 1.01 points year-on-year.
In terms of satisfaction, Zhejiang has performed well.
The five provinces with the highest outpatient satisfaction are: Zhejiang, Hunan, Fujian, Shandong and Sichuan.
The high level of patient satisfaction does not prevent medical treatment outside the province.
In 2019, there were 5.882 million cases of patients seeking medical treatment in tertiary public hospitals nationwide (judging whether the patient was treated in a different place according to the patient's place of work and residence), accounting for 6.74% of the annual discharged patients, which was basically the same as in 2018. The main diseases of medical treatment outside the province are chemotherapy for malignant tumors, pneumonia, cerebral infarction, bronchial and pulmonary malignant tumors, angina, follow-up examination after treatment of malignant tumors, chronic ischemic heart disease, etc.
First of all, let's take a look at the outflow of patients: the three provinces of the "Package Mail Zone" have all been shortlisted in the top 5 in the country.
The provinces with the largest number of outflows are still Anhui, Hebei, Jiangsu, Zhejiang and Henan.
Why is the word "still" there? Because 2018 is also the case.
Although the number of outflow patients has increased, the outflow rate of patients in Hebei, Zhejiang and Henan (the proportion of inpatients who have flowed out of this province for medical treatment in different places in the whole country) has decreased;
The provinces with the largest proportion of outflow patients in the province are still Tibet, Anhui, Inner Mongolia, Hebei and Gansu.
Let's take a look at the influx of patients, and look at the people of the whole country to see a doctor in the "package mail area".
The top 5 provinces with the largest inflow of inpatients are still Shanghai, Beijing, Jiangsu, Zhejiang and Guangdong, accounting for 52.7% of the country's off-site medical patients, down 0.9 percentage points compared with 2018.
Among them, the inflow rate of off-site patients in Beijing, Jiangsu and Guangdong (the proportion of inpatients in different places in different places in the country in the proportion of inpatients who receive medical treatment across provinces) has declined, and the relative number of patients admitted to different places in Zhejiang has risen from the fifth place in 2018 to the fourth place in 2019;
The provinces with the largest inflow of patients accounting for the largest proportion of hospitalized patients admitted to the province are Shanghai, Beijing, Tianjin, Ningxia and Chongqing.
Yangtze River Delta "special situation"
How to view the high external flow of patients in the three provinces in the "free mail area"?
If the medical level in Jiangsu and Zhejiang is not good, no one will agree with such a view.
After all, in the latest list of "Fudan Top 100 Hospitals", Jiangsu and Zhejiang have 5 hospitals shortlisted.
After all, there is the strongest "prefectural and municipal" hospital here, and the First Affiliated Hospital of Soochow University ranks in the forefront of China's top 100 hospitals as a "prefectural and municipal" hospital.
After all, there are also "prefectural and municipal treasure hospitals" such as the Optometry Hospital of Wenzhou Medical University, which has achieved industry leadership in the field of specialties.
It can be said that Zhejiang and Jiangsu have both national-level high-level hospitals, as well as urban and county-level medical institutions with strength that cannot be underestimated, and the development of grass-roots medical and health institutions is also at the forefront of the country.
The "Circular of the General Office of the National Health Commission on the Performance Appraisal of National Tertiary Public Hospitals in 2018" gave the answer, and the biggest reason was population mobility.
The "2018 National Examination" analysis believes that in provinces with a large outflow of patients, in addition to the Yangtze River Delta and neighboring provinces due to economic development, convenient transportation and other factors, the tertiary public hospitals in other provinces are weak as a whole, and it is difficult to meet the needs of the local people for high-quality medical services.
The leaders of the Anhui Health Commission answered this question even more frankly. The main reason why residents in Anhui Province choose to seek medical treatment outside the province is the population movement.
As a major labor-exporting province, the number of people insured by various basic medical insurance in Anhui Province has reached 66.5 million, but according to the data of the seventh national census, the permanent population of Anhui Province is 61.02 million, and 5.5 million people are insured in our province and live permanently in other places. They may choose to see a doctor in their usual place of residence and return to Anhui to reimburse their medical expenses.
The population data of the "Seven Pu" show that under the integration of the Yangtze River Delta, the population movement in the region is highly frequent.
In 2020, the inflow population of Zhejiang Province was 16.186 million, accounting for 25.1% of the total permanent population, that is, 1 in every 4 permanent residents came from outside the province.
In 2020, the top three provinces in Zhejiang Province in terms of inflow population were Anhui, Guizhou and Henan, with inflows of 3.139, 282.8 and 2.466 million people respectively, accounting for 19.4%, 17.5% and 15.2% of the total inflow population from outside the province.
Among them, Anhui has once again become the province with the largest inflow of population into Zhejiang since the Sixth Census in 2010; the population of Henan into Zhejiang has jumped from the fifth place in 2010 to the third place, with an average annual growth rate of 7.3%.
There are many plateaus and few peaks
Facing Shanghai's "siphon" and never "lying flat"
Jiangsu and Zhejiang "peak" plan
Shanghai is a model student, Zhejiang is a superior student, Jiangsu is a top student, and Anhui is a catch-up student, which is the most vivid metaphor for one city and three provinces in the Yangtze River Delta on the Internet.
The outflow of patients from Anhui, Zhejiang and Jiangsu is largely to Shanghai.
The 14th Five-Year Plan for the Allocation of Provincial Medical Resources in Zhejiang Province believes that the integration of the Yangtze River Delta poses new challenges to regional competition and cooperation of medical resources.
"The regional integration of the Yangtze River Delta has exacerbated the siphon effect of Shanghai on high-quality medical resources, and the convenience of location and transportation has further reduced the time cost of obtaining high-quality medical services in Shanghai, which has led to the outflow of medical talents and patients in the province to a certain extent." Under the overall requirements of the integrated development of the Yangtze River Delta region, provincial medical resources urgently need to further clarify the positioning of medical services, take the initiative to explore in building a medical highland, further do a good job in dredging, merging, and upgrading articles, extend the space for providing high-quality medical and health services outside the province and radiate to the Yangtze River Delta, and continuously improve the spillover effect of Zhejiang's medical and health care. ”
Jiangsu is also facing up to its own shortcomings and gaps.
"Xinhua Daily" has reported that There are many medical colleges and universities in Jiangsu, the top three hospitals are lined up, and the overall medical service capacity is in the forefront of the country, but compared with Beijing, Shanghai, Guangdong and other areas where high-quality medical resources are concentrated, our province shows a situation of "more plateaus and fewer peaks", and there are still problems such as too many patients transferring to other places in the province, the slow development of new technologies and new projects, and there are not many influential large hospitals in the country.
The number of patients transferred out of the province ranks among the top 5 in the country, and many patients suffering from difficult and critical diseases often have to travel thousands of miles to Beijing, Shanghai and other first-tier cities where high-quality medical resources are concentrated, which increases the burden of the people to see a doctor. Therefore, Jiangsu urgently needs to rely on the platform of national medical centers and regional medical centers to build national and top medical talents and clinical specialties.
Although Jiangsu and Zhejiang, which are already "excellent students" in the eyes of others, still put forward higher requirements for themselves, and invariably propose to create a "peak".
Zhejiang will accelerate the construction of key disciplines and actively plan major medical innovation platforms. In terms of the "Medical Peak" program:
High standards to build 6 professional national regional medical centers such as infectious disease medical centers, comprehensive national regional medical centers and cardiovascular diseases.
Carry out the "four batches" peak discipline plan, and give priority to the development of 10 medical key cultivation specialties (disciplines) such as human organ transplantation.
Explore the construction of new advanced technology platforms and exemplary research wards. Promote the transformation and industrialization of major achievements to a total of more than 100 items.
The "14th Five-Year Plan for health and health development in Jiangsu Province" proposes to "build a peak", implement the project of improving the quality and expansion of high-quality medical resources, strengthen the construction of national medical centers, national and provincial regional medical centers, and promote the high-quality development of public hospitals beyond the norm.
During the "14th Five-Year Plan" period, the province will strive to create a national medical center in four categories of severe diseases, rehabilitation, blood and skin diseases, build a national regional medical center in 13 specialty categories such as children, cancer, cardiovascular, respiratory, geriatrics, obstetrics and gynecology, etc., build a total of 50 provincial-level regional medical centers in about 20 categories, and strive to create about 7 national clinical key specialty construction units every year, forming more disciplines, specialties and more high-level hospitals that meet the needs of the people with influence in the country. (The original title is: People from all over the country come to the "package mail area" to see a doctor!) Zhejiang and Jiangsu are large provinces with patient outflow! ）
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