Primary health care is not "low" health care, but basic health care. It should be said that in addition to the specialized diagnosis and treatment of secondary and first-class hospitals, most of the other medical and health services belong to the scope of primary health care, which is mainly manifested in public health services and primary diagnosis. Such a wide scope is in a fundamental and strategic position in the entire medical and health system, and the task of high-quality development is more urgent and meaningful. Specifically, there are three aspects of transformation:
1. From accessibility to rationality. Primary health care mainly solves the problem of access to health services, which is the "availability" of resources and services. In the stage of relatively abundant medical and health resources, the main contradiction faced by primary health care is the rationality of services, that is, the adaptability of the severity of the disease and the services needed, and the "reasonableness" of resources and services. If reasonable, it is conducive to the effective use and optimal allocation of resources. If it is unreasonable, it will cause the coexistence of idle and wasteful resources, and increase the medical burden of the whole society. This is a phased change in the development of primary health care, and a phased shift in priorities must be made.
2. From the supply side to the demand side. The idea of primary health care to solve the problem of accessibility is to continuously build institutions, expand the allocation of institutional resources, increase the supply of services, and achieve the goal as long as the patient comes to the clinic, but does not care which hospital the patient chooses, how to make the choice, whether the choice meets the actual needs of the disease, etc. Originally, due to the limitations of factors such as the ability to pay, transportation and communication conditions, the way to realize the demand is generally to choose nearby. After the arrival of aging and chronic diseases at the same time, the demand for diseases has become more complex, coupled with the fact that various conditions support higher demand choices, a large number of general diseases are no longer satisfied with the accessibility of primary health care resources, but directly go to large hospitals to use secondary health care, health care and other specialized resources, thus causing unreasonable problems. To solve such an unreasonable problem, relying on the past to solve the problem of accessibility has been powerless, we must achieve a fundamental change in concepts and methods, mainly relying on health management, change the service mode of waiting for patients to come to the door, take the initiative to manage everyone's needs, realize the specific docking of demand and supply, and change from the supply side to the demand side.
3. From competition to cooperation. The service supply system on which primary health care depends, the relationship between institutions and institutions has undergone major changes, which is from the original hierarchical business guidance relationship to the actual existence of a relatively full competitive relationship, laissez-faire technology competition has seriously weakened the strategic position of primary health care, the primary diagnosis is not stronger and stronger but weaker and weaker, the disease is coerced by competition, bringing about the irrational use of resources, primary health care resources idle waste and superior secondary health care resources, ** The unintended use of health care resources exists at the same time, and the medical and health order is out of control. The problem of competition is not a problem that can be solved by primary health care alone, but it is highly relevant to primary health care and is related to the stability of the primary health care framework.