在长宁，家庭医生为患者健康尽心尽责 “守门”；在松江，“集纳式”的诊断中心把优质资源送到家门口；在青浦，“新农合单病种预付”让慢性病患者既控制病情又省了费用……近年来，本市不少区县和医疗机构积极作为，推出了一系列具有探索性的医改新措施，亮点频现，效果初显。本报今起推出一组“医改新亮点”报道，介绍相关案例并请专家评点，期望对全市推广这些惠民利民的举措有所推动。读者可发传真67289226或发邮件至kjb@jfdaily.com参与。

In changning,The family doctor for patients health conscientious "gatekeepers";In songjiang,"Market offer type"The quality of diagnostic center resources to the door;In qingpu,"New farming combined single disease in advance"Let the patient is chronic disease control their condition and saved cost...In recent years,This city many districts and counties and medical institutions as positive,Rolled out a series of exploratory medical new measures,Window frequency is,Incipient effect.Our newspaper this up out of a group"Reform, new luminescent spot"reports,Introduce related cases and please experts commented,We expect to the promotion of the country and the measures to promote.Readers can fax 67289226 or email to kjb@jfdaily.com participation.

　　家庭医生黄耀庭的诊室位于新华社区卫生服务中心的一楼转角。长宁区推出家庭医生负责制以来，黄医生管理的慢性病人一路飙升，已多达700余人，而且首诊100%在社区。

The family doctor HuangYaoTing office is located in xinhua community health service center on the first floor of the corner.Changning district launched since the family doctor responsibility system,Yellow doctor management of chronic patients soared,Has as many as 700 people,The first diagnosis and 100% in the community.

　　除了诊室，黄医生最常去的是隔壁陈家巷社区老年活动室。活动室里，黄医生还没到，几位居民已叽叽喳喳。“我这鼻子里有块息肉总是不舒服”，“喷盐水最有效，黄医生说了，息肉就像家里的腌肉一样，撒一把盐，水分蒸干了，它就缩小了”；“天冷肩周炎又犯了，不知怎么弄”，“黄医生不是说了，电吹风加红花油，带着热度活血，最有效”……“黄医生保健理论”在社区的名气越来越响。

In addition to clinic,Yellow doctor most often go to the next lane community elderly activity room.Activity room in,Yellow doctor hasn't arrived,Several people have twitter."My nose has small polyps always uncomfortable","The most effective spray brine,The doctor said the yellow,Polyp is like home like bacon,And a salt,Still moist the,It reduces the";"The day is cold periarthritis of shoulder and made,Don't know how to do","Yellow doctor is not said,Hair dryer and safflower oil,With the heat invigorate the circulation of blood,The most effective"..."Yellow doctor care theory"In the community's fame getting louder and louder.

　　社区家庭医生如何吸引居民，一直是个瓶颈。长宁区近年来探索新途径，用黄耀庭的话来说，“把病人吸引过来，我手里有三张牌”。

Community family doctors how to attract people,Has always been a bottleneck.Changning district in recent years to explore new ways,With HuangYaoTing words,"The patient attracted,My hand has three CARDS".

　　第一张“牌”是优惠。两年前，长宁区将“基本医疗保险、基本医疗服务、政府医疗救助、社会组织医疗帮扶”联合起来，形成“四医联动”。纳入“四医联动”范围的居民，享受优惠幅度相当大：社区问诊，个人自负部分95%免费；由家庭医生转至二级医院，个人自负部分90%免费，同时可走绿色通道。黄耀庭共有38个“四医联动”病人，其费用都大幅下降。如患糖尿病的许建国，以前各家大医院轮着看，每次诊疗费不下百元，现在次均费用支出仅为个位数。至今年8月底，长宁区共发放“四医联动”保障卡10208张，这意味着这些人的首诊留给了家庭医生。

The first"brand"Is preferential.Two years ago,Changning district will"Basic medical insurance/Basic medical service/The government medical assistance/Social organizations medical aid"together,formation"Four medical linkage".into"Four medical linkage"Range of residents,Enjoy the margin of preference is quite large:Community inquiry,Individual conceit part 95% free;The family doctor turn to secondary hospital,Individual conceit part 90% free,At the same time can go green channel.There are HuangYaoTing thirty-eight"Four medical linkage"The patient,The charges will be plunged.Such as diabetes XuJianGuo,Before each big hospital looking round,Every time fee not less than one hundred yuan,Now time is only single-digit are expenses.Until the end of August this year,Changning district were issued"Four medical linkage"Security card 10208 copies,This means that these people first diagnosis to the family doctor.

　　第二张“牌”是大医院的转诊便利。长宁区所有社区卫生服务中心与中山、华山、长宁区中心医院、同仁医院等建立起了转诊关系。乳腺癌术后病人陈女士，与黄耀庭签约有些时日了，每次随访，老伴总陪伴左右。

The second"brand"Is big hospital referral convenience.Changning district all community health service center and zhongshan/huashan/Changning district central hospital/Tongren hospital and established a referral relationship.Breast cancer patient ms. Chen,And HuangYaoTing signing some time,Every time follow-up,His wife always companions.

　　前不久，老伴突然下肢疼痛，走路一瘸一拐，初步诊断为糖尿病并发症。黄医生随即开出同仁医院血管外科检查单，次日，老伴前往同仁医院“转诊窗口”，没排队就做了检查，当天下午拿到报告，“要是我自己去排队，还不知等到什么时候呢。”自此，夫妻俩都成了黄医生的签约病人。黄医生打开手机，找到“病人文件夹”，上百个病人姓名跳出来，“他们都是朋友带着，家人领着，口口相传自愿跟我签约的。”

Not long ago,His wife suddenly lower limb pain,Walks with a limp,A primary diagnosis of diabetes complications.Yellow doctor immediately open tongren hospital vascular surgical inspection list,The next day,His wife to tongren hospital"Referral window",Do not line up the check,In the afternoon to the report,"If I'm going to line up,Also don't know until when."Since then,Both the husband and wife have become yellow the signing of the patient.Yellow doctor open the cellular phone,find"The patient folder",Hundreds of patients name jump out,"They are friends with,Family took,With my mouth voluntarily signed."

　　实力则是家庭医生第三张也是最重要的“牌”。区卫生局局长葛敏介绍，为给家庭医生搭建良好平台，区内开出沪上首个家庭医生工作室——“陈华工作室”，各种培训进修机会也逐渐增多。数据显示，区内80%的家庭医生均为本科以上学历。黄耀庭也有绝招。他治疗一名高血压病人的案例，至今在社区流传。去年岁末，一个老伯血压突然居高不下，看过多家医院、吃了不少药也不起效。黄医生在与他聊天后，最终找到“病根”——原来，老人担心保姆春节回家，自己没人照顾，“愁”得血压飙升。在黄医生的好心劝说下，保姆竟被打动了，决定节后再回家，老伯血压也降了下来。新华社区卫生服务中心党委书记孙阓说，“专科能治病、全科管全家”，这便是家庭医生吸引居民的优势所在。

Strength is the third family doctor zhang is also the most important"brand".District health bureau chief GeMin is introduced,To build a good family doctor platform,The first family doctor leave Shanghai studio --"Chen hua.how studio",Various training learning opportunities is increasing.Data display,The 80% of family doctors are bachelor degree or above.HuangYaoTing also have unique skill.His treatment of a case of a patient with hypertension,In the community spread so far.This last year,A high blood pressure suddenly old man,See too many hospitals/Eat a lot of medicine also does not work.Yellow doctor and he after chatting,Finally find"Know the disease"-- so,The old man worried about Spring Festival home nanny,No one to take care of yourself,"sorrow"To blood pressure surge.In the yellow doctor kindness persuasion,Nanny have been moved,After decided to go home,The blood pressure also drop down.Xinhua community health service center secretary of the party committee Hui sun said,"College can cure/General tube family",This is the family doctor to attract people's advantage.

专家点评 Expert comments

　　复旦大学社会发展与公共卫生政策学院院长梁鸿教授：无论在世界哪个国家，医改成功都得益于两条：完善的医保制度、有序高效的服务体系。在形成高效有序的服务体系方面，长宁区推行家庭医生责任制，也即“向百姓负责”，并通过逐步推进策略，从最需要的人群做起，不断满足社区居民的健康需求，最终形成良好互动。在逐步推进的过程中，家庭医生能力得到提升，社区服务覆盖的人群扩大，这对完善社区“健康守门人”功能很有借鉴。（记者 顾泳）

Fudan university social development and public health policy, dean of the college of LiangHong professor:No matter which country in the world,Reform success thanks to two:Perfect medical insurance system/Orderly and efficient service system.In the formation of efficient and orderly service system,Changning district family doctor system implementation,namely"To the people responsible for",And through the gradually advance the strategy,From the need to start the crowd,Constantly meet the health needs of the community residents,Eventually form a good interaction.In the process of gradually,The family doctor ability get promoted,Community service coverage of the crowd to expand,The perfect community"Health the gatekeeper"Function is a reference.(Reporter GuYong)