Yuhuan Healthcare Reform (Phase II): Initial Consortium of 14 Primary Care Institutions Forms Integrated Health Community Model

In Yuhuan City’s healthcare reform, the core lies in medical institutions at all levels. The vast majority of medical services enjoyed by patients are delivered within these medical institutions.

Currently, Yuhuan City has a total of 273 various types of healthcare institutions, including 3 public hospitals, 1 maternal and child health hospital, 3 private hospitals, 1 community health service center, 10 township health centers, and 185 village clinics and community health service stations.

This initiative, launched by Yuhuan City, aims to deepen healthcare reform, accelerate the establishment of a tiered diagnosis and treatment system, build a rational and orderly medical service framework, enhance the service capacity of medical institutions, and construct a three-tier county–township–village medical service system led by the City Central Hospital, thereby further achieving the goal of managing serious illnesses within the county.

At the end of 2018, leveraging its role as a pilot for comprehensive provincial healthcare reform and integrating the development of medical consortia, Yuhuan implemented the construction of Health Communities (hereinafter referred to as “Health Communities”) across the city. This initiative strengthened the “prevention + treatment + rehabilitation” health management model, established a complete ecological chain for disease prevention and control, and facilitated the transformation of healthcare services from being “treatment-centered” to “health-centered.”

Previously, the “Internet + Healthcare” remote free clinic campaign, spearheaded by the Yuhuan Municipal Health and Family Planning Bureau of Zhejiang Province, was simultaneously held at the Damaiyu Central Health Center and the Qinggang Town Health Center in Yuhuan City. More than 10 patients at these health centers used an internet platform to schedule remote consultations with specialists from Shanghai Huashan Hospital, Zhejiang Provincial People’s Hospital, and Wenzhou Traditional Chinese Medicine Hospital.

Ms. Ye, a resident of Damaiyu, had been suffering from recurrent abdominal pain, postprandial fullness, and acid reflux for five years. She scheduled an appointment with Dr. Chen Jian, Chief Physician in the Department of Gastroenterology at Shanghai Huashan Hospital. Based on the medical records uploaded by the patient, including ultrasound, laboratory test, and CT reports, Dr. Chen carefully reviewed her medical history, various test results, and previous treatments, and proposed a diagnostic and treatment plan.

“After the expert consultation, I learned that my condition had not worsened, and I instantly felt much relieved. This remote consultation model is so convenient; it allows me to see specialists from major hospitals without having to travel far,” said Ms. Ye.

The efficiency and convenience of telemedicine are attributed to Yuhuan City’s initiative in May last year to integrate medical and health service resources and establish a city-wide Health Community.

The construction of the health consortium centers on medical institutions within the city.

Yuhuan City adheres to the guideline of “prioritizing primary care, driven by reform and innovation, emphasizing prevention, placing equal importance on traditional Chinese medicine and Western medicine, integrating health into all policies, and promoting joint construction and shared benefits.” By coordinating medical and health service resources and establishing a city-wide Health Community, Yuhuan has achieved comprehensive unified management of personnel, finances, and materials within the community. It has built a complete ecological chain for disease prevention and control from the grassroots up, thereby safeguarding residents’ health in an all-around and full-lifecycle manner.

In accordance with the requirements of the Yuhuan Municipal Party Committee and Municipal Government, Yuhuan has designated all three municipal-level public hospitals and 11 township health centers (including central health centers) across the city as entities for the construction of Health Communities, forming two such Health Communities. One Health Community comprises the Municipal People’s Hospital, the Municipal Hospital of Traditional Chinese Medicine, Kanmen Central Health Center, Damaiyu Central Health Center, Yucheng Subdistrict Community Health Service Center, Lupu Town Health Center, and Haishan Township Health Center. The other Health Community consists of the Second Municipal People’s Hospital, Chumen Town Health Center, Qinggang Town Health Center, Shamen Town Health Center, Ganjiang Town Health Center, Longxi Town Health Center, and Jishan Township Health Center.In addition to the aforementioned public medical institutions, designated village clinics are also included. This year, private medical institutions within the jurisdiction will be gradually incorporated on a voluntary basis.

In accordance with the work objective plan, a relatively scientific division of labor and collaboration mechanism, as well as a smooth two-way referral system, have been initially established within the Health Community. This aims to provide patients with continuous, high-quality medical services, enhance the overall operational efficiency of the healthcare service system, and guide the joint construction and sharing among healthcare providers, health insurance entities, and residents, thereby achieving aligned interests among the three parties. The overarching goals include gradually attaining a primary care visit rate of over 65% and an in-region treatment rate of over 85%. Efforts will be made to achieve the comprehensive objective of “advancing healthcare development, benefiting the public, ensuring controllable fiscal investment, safeguarding health insurance funds, and achieving satisfaction among the public, medical personnel, and party committees and governments.”

Community health service stations and village clinics designated as medical insurance providers within the jurisdictions of township health centers (including central health centers) in Yuhuan City are all integrated into the Healthcare Community. Meanwhile, the City Center for Disease Control and Prevention and the City Maternal and Child Health Hospital have each dispatched professional personnel to form two general practice public health teams, which provide targeted support to the two Healthcare Communities by offering guidance and evaluating outcomes in disease surveillance, health maintenance, and public health services.

For medical institutions within the Health Community, improve the tiered diagnosis and treatment system; standardize the decentralization of healthcare resources; unify the allocation of healthcare resources; establish a standardized two-way referral mechanism; and strengthen the construction of primary-level rehabilitation medical systems. Unify information management; unify health management; reform health insurance payment methods; reasonably adjust medical service prices; strengthen financial management; reform personnel and compensation management systems; and improve performance evaluation and incentive mechanisms.

To strengthen oversight of member units within the Health Community, the Yuhuan City Health Inspection Institute established the Yuhuan City Health Community Committee, the Yuhuan City Health Community Management Center, and the Yuhuan City Health Community Council, thereby incorporating medical institutions into the Health Community for coordinated management.

The “Health + Finance” project is a crucial component of Yuhuan’s efforts to advance the construction of health communities. Spearheaded and designed by the Yuhuan Municipal Health and Family Planning Bureau, this “Internet+” initiative builds upon the family physician management system and integrates resources from the Yuhuan Municipal Human Resources and Social Security Bureau, banks, commercial insurance companies, medical technology firms, and social work organizations. It embeds health management services into financial products and commercial insurance offerings. The project aims to improve the delivery of medical services through an online-offline integrated operational model, raising participants’ awareness of prioritizing and investing in their health. By changing public healthcare-seeking behaviors, it seeks to control medical costs, enhance the overall health status of Yuhuan’s population, and truly realize “smart healthcare.”

“Smart Healthcare” encompasses the establishment of an online platform for appointment scheduling, enabling patients to register independently via the internet; the implementation of in-clinic QR code scanning and self-service payment kiosks for billing and settlement; and the launch of family doctor contracting services to facilitate chronic disease management, among other initiatives. By opening these “green channels” and continuously advancing informatization construction, the system ensures that “a single card suffices for the entire medical journey,” thereby enabling rapid access to medical care for the public and enhancing the overall healthcare experience.

Yuhuan City’s Health Community commissioned WeDoctor to establish a Telemedicine Center, providing services such as remote consultations and remote training to healthcare institutions within the community. It also offers online appointment registration for outpatient visits and hospital admissions via a remote platform for patients requiring referral to higher-level hospitals for further diagnosis and treatment.

After integrating the healthcare and insurance needs of Yuhuan, WeDoctor has leveraged internet technologies and medical health resources to provide an information platform with big data analytics capabilities. This initiative promotes the decentralization of high-quality medical resources across China, enabling residents of Yuhuan to access premium medical and health services within their local communities.

Currently, all three public hospitals in Yuhuan City have implemented smart medical services, supporting WeChat and Alipay payments via self-service kiosks, as well as medical expense settlements through mobile APP terminals. Yuhuan People’s Hospital and the Second Municipal People’s Hospital have also introduced scan-to-pay functionality within consultation rooms, establishing a “regional closed-loop intelligent healthcare platform” that integrates appointment scheduling, registration, payment, diagnostic tests and examinations, treatment, hospitalization, and final settlement.

It is reported that since the beginning of this year, Yuhuan City has conducted more than 200 remote consultations, enabling patients to access high-quality medical resources from across China without leaving their homes, thereby effectively alleviating the difficulty of accessing medical care.

In addition to building a robust learning platform through “Internet + Healthcare” to enhance primary care diagnosis and treatment capabilities, Yuhuan City and WeDoctor are also exploring operational models for commercial health insurance.

In October this year, Yuhuan City launched the promotion of the “Health + Finance” chronic disease management program. As Zhejiang Province’s first “Internet+” initiative to integrate health management services into financial products and commercial insurance, the project is led by the Yuhuan Municipal Health and Family Planning Bureau. The medical technology platform WeDoctor is responsible for developing the informatized health community platform, which integrates products and services from providers of smart wearable devices, commercial insurance, and genetic testing. This initiative offers residents within its jurisdiction comprehensive, full-cycle health management and health protection.

Take KingMed Diagnostics as an example. As a key partner in Yuhuan City’s “Health + Finance” initiative, KingMed Diagnostics has helped enhance the testing capabilities for hypertension, diabetes, and other conditions at county-level hospitals and community health centers in Yuhuan. The company shares expert and technical resources, providing on-site expert guidance and professional training for medical staff to regional healthcare institutions.

In addition to enterprises, Yuhuan has also incorporated the power of social work organizations into its chronic disease management efforts.

Tianyi’s collaboration with the Yuhuan Municipal Health and Family Planning Commission began in 2015 with the establishment of “Health Huts.” Utilizing case work, group work, and community work methodologies, Tianyi social workers have carried out chronic disease management initiatives in areas such as Chuzhou Cultural City in Chumen Town, Shanbei Village, Changcheng Hotel, and Dongfang Middle School. Advocating for joint medical-social development, they strive to provide enhanced services to individuals with chronic diseases. Chronic disease management has been further supported through rehabilitation assistance for patients, self-management groups, and various health-promotion activities. During this period, the construction of “Healthy Villages,” service delivery in functional communities, and the implementation of the Patriotic Health Campaign have provided Tianyi social workers with invaluable experience in chronic disease management.

This social work service is jointly funded by relevant government departments, such as the local township government and the Health and Family Planning Bureau, as well as enterprises like banks, with an annual cost of over 2 million yuan.

Moving forward, Tianyi will deliver diverse services through both online and offline channels, while launching more targeted offerings tailored to users’ varying needs to enhance customer satisfaction.

The innovative model in Yuhuan has also received encouragement from the Bureau of Disease Control and Prevention under the National Health Commission. Following his field research in Yuhuan, Director Mao Qunan pointed out that Yuhuan’s “Health Community” construction model is novel, with robust measures in place, and many health management mechanisms have taken initial shape. He expressed hope that Yuhuan would continue to explore new pathways, leverage innovative initiatives such as “Health + Finance,” play a leading and demonstrative role, optimize the allocation of medical resources, and make healthcare more accessible for the public.

Taking Yuhuan Second People’s Hospital and Qinggang Town Health Center in Yuhuan City as examples, this article illustrates the smart medical services developed under the Healthcare Community model and highlights their key features.

Yuhuan Second People's Hospital, founded in 1932, is a Grade II Class A general hospital and one of the medical and health centers in Yuhuan City. It is also a designated provider for the county’s rural cooperative medical insurance scheme. Furthermore, Yuhuan Second People's Hospital is a nationally recognized "Baby-Friendly Hospital," a Health Promotion Hospital in Zhejiang Province, and has been accredited as a Provincial Green Hospital, Provincial Safe Hospital, and Provincial Smoke-Free Hospital. It maintains collaborative partnerships with Zhejiang Hospital and Taizhou Central Hospital.

On June 13 last year, Yuhuan Second People's Hospital and the township health centers of Chumen, Qinggang, Shamen, Ganjiang, Longxi, and Jishan jointly established the “Yuhuan Second People's Hospital Health Community,” with the unveiling ceremony marking its official launch.

It is reported that members of the Yuhuan City Healthcare Community will be uniformly under the leadership of the Yuhuan City Healthcare Community Management Committee. A Healthcare Community Council will be established internally to centrally allocate medical resources and conduct unified performance evaluations. The Healthcare Community will standardize the decentralization of medical resources, strengthen the “Dual Decentralization and Dual Improvement” initiative between member units and superior hospitals, and explore ways to maximize the utilization of medical resources within the region. It will improve the medical resource sharing center by exploring the establishment of shared centers for imaging diagnosis, electrocardiogram (ECG) diagnosis, and medical laboratory testing, thereby achieving regional sharing of resources and data. Unified health management will be implemented to help member units enhance their medical technical capabilities and improve the regional medical treatment system. Furthermore, reforms in personnel and compensation management systems will be explored, staff training within the Healthcare Community will be strengthened, and the overall professional competence and service quality of the Healthcare Community will be enhanced.

Fei Lun, President of Yuhuan No. 2 People’s Hospital, stated that the Yuhuan No. 2 People’s Hospital Health Community will raise its standards and address existing weaknesses by establishing a comprehensive “prevention + treatment + rehabilitation” trinity health service system. This initiative aims to provide a model for the integrated development of medical resources across the city and achieve smart healthcare services through collaborative efforts within the Health Community.

Within the Yuhuan Second People’s Hospital Health Community, six leadership team members established paired partnerships with six member institutions. Specialist appointment slots, diagnostic resources, and inpatient beds were made accessible to all member institutions, and American Heart Association (AHA) training was conducted across the six member facilities. As of last September, a total of 595 personnel visits were arranged within the Yuhuan Second People’s Hospital Health Community over just three months, leading to a significant increase in outpatient visits at township health centers from July to September.

As a participating institution in Yuhuan’s “At-Most-One-Visit Reform” in the healthcare sector, Yuhuan Second People’s Hospital has not only built a smart hospital but also established comprehensive emergency care centers, including a Chest Pain Center and a Stroke Center. This has enabled the construction of a rapid and efficient medical rescue system for acute and critical conditions, thereby enhancing the capacity to treat patients with major acute diseases.

In September last year, the first "National Standardized Metabolic Disease Management Center" (MMC) in Taizhou was established at Yuhuan Second People's Hospital. Initiated by the Endocrinology Branch of the Chinese Medical Doctor Association and the National Clinical Research Center for Metabolic Diseases, this center piloted its program on diabetes management in Yuhuan City. In collaboration with Damaiyu Central Health Center, Qinggang Town Health Center, and Longxi Town Health Center, it established the first MMC diabetes specialty medical consortium featuring a "Regional Metabolic Center–Community Metabolic Center" model. It is also the only level-II hospital-based metabolic disease research base in China and was honored as one of the "Top Ten MMC Centers in the First Half of 2018."

“MMC” stands for “One Center, One-Stop Service, Unified Standards,” implementing “homogenized and integrated” management. The center offers specialized outpatient clinics for metabolic diseases, diabetic retinopathy, nutrition, dyslipidemia and hypertension, obesity, and thyroid disorders, and conducts related examinations such as blood pressure and weight measurement, patient registration, arterial stiffness assessment, fundus photography, and nerve conduction studies.

Going forward, patients at the MMC will need to register only once to access comprehensive diagnostic and therapeutic services, including full-scale testing, data analysis, disease diagnosis and treatment, and out-of-hospital management via a mobile app. This enables efficient, end-to-end clinical care within the hospital and seamless, comprehensive data synchronization and sharing through the app outside the hospital.

Furthermore, the MMC also conducts training for primary care physicians and promotes diabetes educational materials. Yuhuan has leveraged this platform to advance chronic disease management across the city, enabling such management to truly reach primary healthcare institutions and ensuring the effective implementation of the comprehensive healthcare reform’s “dual decentralization and dual enhancement” initiative as well as tiered diagnosis and treatment for metabolic diseases.

As the first region to officially launch the pilot program for capitation-based reform of outpatient medical insurance payments for patients with chronic diseases in Zhejiang Province, Yuhuan will guide patients to rationally utilize primary healthcare resources, effectively reduce medical costs, and improve the efficiency of medical insurance fund utilization through payment system reform.

The so-called "capitation-based global budget" refers to a mechanism wherein the Yuhuan Health Community, building upon the municipal social insurance agency’s global medical insurance budget framework, comprehensively evaluates outpatient medical costs and medical insurance expenditures for patients with specified chronic conditions (namely hypertension and diabetes) in pilot townships. A per-capita global budget standard is predetermined and paid to the pilot townships, with final settlement conducted at year-end based on the actual medical insurance expenditures for chronic disease patients managed by the pilot family doctor teams. The scope of implementation for this capitation-based global budget covers general outpatient services, excluding hospitalization and special outpatient disease treatment costs.

It is reported that the current pilot program targets selected family doctor teams in Yucheng Subdistrict, Damaiyu Subdistrict, Qinggang Town, and Shamen Town as the first cohort for the capitation-based payment pilot for outpatient medical insurance expenses of patients with chronic diseases, with plans for gradual expansion in the future.

Meanwhile, family doctor teams in pilot townships will receive intensive support from chronic disease specialists dispatched by municipal-level public hospitals under the Health Community framework. This initiative focuses on optimizing treatment plans for patients with poorly controlled blood pressure and blood glucose, providing early warnings for potential complications, and developing personalized health management strategies to achieve precise prevention.

The Municipal Center for Disease Control and Prevention will actively participate in health management, propose prevention and control strategies, and be responsible for retrospective contact tracing and scientific evaluation. The Municipal Health and Family Planning Commission will establish a review panel for chronic diseases complicated by major illnesses to assess whether the daily management provided by family doctor teams is adequate.

Qinggang Town Health Center is a township-level health facility integrating medical care, disease prevention, healthcare services, rehabilitation, health education, and family planning technical guidance. Covering a land area of 4,987.1 square meters with a building area of 2,867.28 square meters, the center has been successively designated by authorities at various levels as a Provincial Standardized Township Health Center, a Class B Township Health Center in Zhejiang Province, a Demonstration Unit for Health Supervision Assistance in Zhejiang Province, a Municipal Standardized Maternal and Child Health Clinic, a Qualified Traditional Chinese Medicine Pharmacy in Taizhou City, a Provincial Five-Star Vaccination Clinic, a Civilized Unit for Elderly Care, and a Township Health Center Satisfactory to the Public.

Implementing contracted services with general practitioners is the foundation for establishing a tiered diagnosis and treatment system. To comprehensively advance contracted services with general practitioners, promote the standardized delivery of such services by general practitioners (family doctors), and further enhance public satisfaction and sense of gain, Qinggang Town Health Center has established a Family Doctor Studio.

Family doctor contract services primarily target chronic disease management. Qinggang Town Health Center offers six types of free medications for hypertension and two types for diabetes. Both individuals enrolled in the family doctor contract service and those under management without a contract are eligible to receive these free medications. Currently, the contracted services for hypertension and diabetes are provided free of charge, while specialized management services incur certain fees. Qinggang Town Health Center provides dedicated management for contracted service recipients, helping them reduce medical costs through various channels.

Qinggang Town Health Center has another notable feature in its contracted services. Upon signing up, patients receive a complimentary keychain, coin purse, or card holder printed with the name and contact number of their contracted physician. This ensures high visibility and serves as a subtle yet effective reminder, particularly for elderly patients with declining memory or limited mobility. Should they feel unwell, they can directly call their contracted doctor, making the process both convenient and efficient.

Qinggang Town Health Center also benefits from the support of expert teams affiliated with higher-level hospitals. When the health center is unable to meet certain medical needs of local residents, patients are scheduled for consolidated appointments, allowing the expert team to provide on-site guidance, conduct examinations, and adjust treatment plans. For patients with limited mobility, experts will visit their homes to deliver diagnosis and treatment directly.

Like municipal-level public hospitals, Qinggang Town Health Center can also conduct consultations with specialists from Grade 3A hospitals across China via remote outpatient services on an information technology platform. If patients have a preferred treating physician, they can engage in video consultations with specialists at major hospitals, accompanied by their local physicians.

A patient named Wang Wenhuan is under care at Qinggang Town Health Center. The patient has experienced dry mouth and polydipsia for over 10 years and was diagnosed with diabetes approximately 8 years ago. In 2017, ulceration developed in the left foot. Despite seeking medical attention from various providers, the condition remained poorly controlled. On August 1, 2018, the patient was hospitalized at Yuhuan Second People's Hospital but discharged against medical advice on August 3. On August 5, the patient voluntarily sought treatment at Taizhou Central Hospital and was hospitalized for 31 days. After discharge, the patient continued to experience intermittent pain and discomfort in the sole of the foot during walking and physical activity.

Later, the patient consulted her family physician, Dr. Yang Caixue. After reviewing the case, Dr. Yang scheduled a remote consultation with Director Hu Jiang of the Department of Endocrinology at the Second Affiliated Hospital of Zhejiang Chinese Medical University through the WeDoctor platform.

Following the remote consultation, Director Hu Jiang recommended further examinations, including funduscopy, routine urinalysis, and assessment for neuropathy. He also adjusted the patient’s existing medication regimen by adding lipid-lowering and antiplatelet therapies.

In addition to remote consultations, all functions provided by the integrated information platform—such as online appointment registration, two-way referral, and the Xuanhu Tai Traditional Chinese Medicine Intelligent Diagnosis and Treatment System—have been fully implemented at Qinggang Town Health Center. Through smart medical services, public recognition of the health center has improved, leading to a gradual increase in outpatient visits and service volume, as well as a significant rise in hospital revenue.

As Yuhuan City’s “At Most One Visit” reform extends deeper into the healthcare sector, certain longstanding difficulties in seeking medical care are quietly being transformed. “Green channel” initiatives—such as online appointment registration, self-service payment, outpatient medication pickup, and the deployment of expert teams from major provincial hospitals to grassroots facilities—are steadily alleviating previous pain points by enabling patients to consult specialists without traveling long distances, thereby continuously enhancing the patient experience.

In addition to providing patients with an efficient and rapid healthcare experience, major hospitals in Yuhuan City have integrated the “Double Sinking, Two Improvements” initiative to enhance primary healthcare service capacity, continuously improve the organizational management model and operational mechanisms of health communities, and promote the rational allocation and vertical flow of medical resources.

Major hospitals in Yuhuan City have invited experts from Grade A tertiary hospitals in other cities to be permanently stationed locally, establishing channels for expert support at the grassroots level. This enables patients in need to access consultations with specialists from provincial-level hospitals right in their own communities. Currently, Yuhuan People’s Hospital is under the trusteeship of the First Affiliated Hospital of Wenzhou Medical University.

Both lead institutions of the two Healthcare Community Consortia in Yuhuan City have established family doctor support teams, allocating no less than 40% of online appointment slots to family doctors at primary healthcare institutions three days earlier than general public booking channels, thereby providing comprehensive resource support. Family doctors not only provide professional medical guidance and personalized health management for insured residents but also guide social workers on how to assist these residents in their daily lives. Furthermore, they can access various health data of insured residents through the WeDoctor information platform to adjust health management or treatment plans.

Major hospitals in Yuhuan City have subsequently launched home-visit services by primary care family doctors. Contracted physicians proactively provide home-based medical services, such as home hospital beds and nursing care, to key populations including the elderly. Currently, Yuhuan City has more than 50 family doctor contracted service teams, and all primary healthcare institutions have implemented family doctor contracting services.

Establishing family doctor clinics in two municipal-level public hospitals is an innovative measure within the Yuhuan City Health Community initiative. The main objectives are as follows:

I. Enhance the capacity of primary healthcare services and improve the technical proficiency of family doctors. The two leading public hospitals within the Healthcare Community will require township health centers to dispatch physicians to their facilities for training, thereby helping them elevate their diagnostic and treatment capabilities.

II. Leveraging family physician outpatient clinics to facilitate two-way referrals and tiered diagnosis and treatment. Three public hospitals will transfer stable chronic disease patients to township health centers, while referring patients with complex conditions that are difficult to manage at the township level to these three major hospitals.

III. Implementing Health Management. Family doctor outpatient clinics serve as a platform for health management, which is of great significance for patients with chronic diseases such as diabetes and hypertension.

IV. Enhancing patients' trust in township doctors facilitates the implementation of subsequent related medical services.

Dong Yin, a member of the Party Committee of the Yuhuan Municipal Health and Family Planning Bureau, used the Second People’s Hospital of Yuhuan City and the Qinggang Town Health Center as examples to illustrate the family doctor contract service.

Family Doctor Outpatient Services refer to the practice where licensed clinicians from member institutions of the Yuhuan Second People’s Hospital Health Community provide consultations at other healthcare facilities within the community. These services encompass clinical diagnosis and treatment, chronic disease management, two-way referrals, and professional training. While the Family Doctor Outpatient Department is headquartered at Yuhuan Second People’s Hospital, family doctor teams operate on a rotational basis across primary care institutions, including those in Qinggang Town. Through family doctor contract services, these medical institutions achieve genuine mutual exchange and sharing of professional talent.

The Second People’s Hospital Health Community Family Physician Outpatient Service was launched on June 19 last year. Over the past few months of operation, it has served more than 2,000 patient visits, with an average of over 30 patient visits per day.

In the context of family doctor contract services, Yuhuan City has integrated the construction of Health Consortia by incorporating village-level health and family planning officers, as well as nursing and pharmaceutical staff from public hospitals, into contracted teams as health commissioners to optimize resource allocation. Family doctors are dispatched to Hangzhou for targeted, hands-on training to enhance their service capabilities. Comprehensive visits to contracted residents are conducted to ascertain public needs and customize diverse, personalized service packages. Primary care institutions are gradually ensuring a full complement of medications for chronic diseases, exempt from the "one product, two specifications" restriction. Furthermore, family doctor clinics have been established at lead hospitals, where qualified personnel from primary medical institutions provide consultations and participate in ward rounds and case discussions. Each family doctor team is paired with a senior physician (associate senior title or above) from a municipal public hospital to provide comprehensive technical support.

Yuhuan City has continuously enhanced the service capabilities of family doctor contracting teams by integrating medical and health resources within the Health Community, deepening the substance of family doctor contracting services, and improving enrolled residents’ sense of gain and adherence.