Dongguan social security, what is a designated community, what is a designated clinic and what is a designated hospital? Also, how to make a referral?

Designated communities are designated community hospitals and clinics, which belong to designated medical institutions of medical insurance.

Designated community medical institutions include: community health service centers and stations approved by the health administrative department; Clinics, Chinese medicine clinics, health clinics and infirmary.

Designated clinics include: comprehensive outpatient department, specialist outpatient department, traditional Chinese medicine outpatient department and integrated traditional Chinese and western medicine outpatient department.

Designated hospitals include: general hospitals, traditional Chinese medicine hospitals, integrated traditional Chinese and western medicine hospitals, and specialized hospitals; Central hospital, township (town) hospital, street hospital, maternal and child health hospital (institute);

Designated medical institutions refer to medical institutions that have been audited by the administrative department of labor and social security in the overall planning area, signed an agreement with the medical insurance agency, and are determined by the social insurance agency to provide medical services for the insured of the basic medical insurance for urban workers and bear corresponding responsibilities.

The social security department announced the list of hospitals with social security medical qualifications within its jurisdiction. Insured persons choose their own hospitals for medical treatment according to the published list, and then issue medical insurance cards to medical insurance personnel after passing the examination by the social security department. With the medical insurance card, he can go to a designated hospital for medical treatment, and he can reimburse medical expenses according to relevant regulations, otherwise he can't reimburse medical expenses.

Outpatient referral procedure

1, xx basic medical insurance outpatient referral certificate (hereinafter referred to as outpatient referral certificate) is issued by the attending doctor in the hospital, and then it is audited and stamped by the relevant departments of the hospital, and registered by the handling personnel.

2. When the insured person is hospitalized for the first time, he should go through the transfer formalities with his social security card (or medical insurance card) and outpatient referral certificate. Transfer, keep the transfer certificate of the outpatient department.

3, outpatient referral certificate from the date of issuance, valid for 3 months. If it is necessary to continue to be transferred after more than 3 months, the insured shall go to the original hospital to go through the transfer formalities again.

4. After the insured person is transferred to another hospital, he/she can still use the card to seek medical treatment in the original hospital and settle medical expenses online.

Extended data:

The two-way referral system, in short, is "minor illness into the community, serious illness into the hospital."

It means that for patients who only need follow-up treatment, disease monitoring, rehabilitation guidance, nursing and other services, hospitals should publicize, encourage and mobilize patients to transfer to corresponding township hospitals or community health service centers in combination with patients' wishes, and lower-level hospitals will complete follow-up rehabilitation treatment. For patients who can't get better medical services in our hospital, they should be transferred to a higher hospital.

The concept of "referral" is often classified according to the level of hospitals. In addition to the referral between general hospitals at the same level, it can also be divided into vertical referral and horizontal referral. Vertical recommendation includes forward recommendation and reverse recommendation. Forward referral means that the lower level (community) hospitals refer to the higher level hospitals step by step, and reverse referral means that the higher level hospitals refer to the lower level (community) hospitals.

Horizontal referral refers to the referral of the same level of specialist and specialist hospitals.

References:

Baidu encyclopedia-designated medical institutions

Baidu encyclopedia-two-way referral system