A Multi-Tiered Approach to Healthcare

The National Health Commission of China has emphasized the importance of solidifying the hierarchical diagnosis and treatment system in a recent circular. This system aims to provide patients with systematic, equitable, and accessible medical services through a multi-tiered approach.

Initial diagnosis at the grassroots level: Patients first consult with their local healthcare providers, typically at the township or community level.

Based on the patient's condition and the capabilities of the local facility, the attending physician determines if a referral to a higher-level hospital is necessary. This referral system operates in both directions, allowing patients to return to lower-level facilities for follow-up care or rehabilitation.

The system prioritizes appropriate care for different types of illnesses. Acute conditions are treated at higher-level hospitals, while chronic diseases are managed at the primary level.

Collaboration between different levels of hospitals ensures continuity of care and efficient resource utilization.

By 2025: Establish a smooth two-way referral system within designated medical alliances.

Implement a seamless referral system for transferring patients within provinces.

Achieve full effectiveness of the hierarchical diagnosis and treatment system, ensuring patients receive the appropriate level of care at each stage.

Attending physicians: Responsible for initial assessment and referral decisions based on patient needs and facility capabilities.

Facilitate the transfer process between departments within the same facility or to other hospitals.

Provide specialized diagnosis and treatment for complex or rare conditions.

Manage chronic diseases and provide follow-up care after the acute phase.

Zhejiang province has actively implemented the hierarchical diagnosis and treatment system, demonstrating its effectiveness. The province has established a network of primary medical institutions, tertiary hospitals, and specialized hospitals, connected through an online referral platform. Additionally, they have developed a "digital human" powered by artificial intelligence to provide patients with one-stop services, including appointment booking, report inquiries, and medication guidance.

The hierarchical diagnosis and treatment system represents a significant step towards improving healthcare accessibility and quality in China. By optimizing resource allocation, facilitating efficient referrals, and leveraging technology, the system aims to provide patients with the right care at the right time, regardless of their location or condition.