According to the Municipal Health and Family Planning Commission, the city has implemented pioneering work in setting up a pilot of grading clinics in Dangyang of Yichang. The preparatory work in setting up a pilot of grading clinics will be completed before March 30th in Dangyang. And the grading clinics system will be officially started before April 1st in the city to ensure that the clinical rate reach to 90 percent in the whole city before the end of this year.
　　A better health care system will be established with the implementation of grading clinics to improve the system of first basic diagnosis, two-way referral flow and grading diagnosis and treatment, to stable the cooperation and coordination mechanism of county-level public hospitals and primary health care institutions as well as city hospitals, and to establish a more convenient referral channels for different levels of medical institutions.
　　Different clinics systems in different hospitals
　　After the implementation of the grading clinics system for diagnosis and treatment, different clinical ranges will be Pided in different levels of hospitals according to the relevant provisions of the difference between the prevalence of diseases and the various medical institutions at all levels as well as surgical grade service capabilities, technology access, etc.
　　When the insured (co) patients need to be hospitalized or (transfer) hospital, in principle, he/she should receive the primary diagnosis in primary health care institutions within the overall area (village clinics, community health service stations, community health centers, rural health centers, rural health center) or designated medical institutions for the first time, then medical treatment or referral should be selected and determined according to conventional treatment and treatment of diseases directory.
　　For the area without town or township hospitals and community health service centers (community), the actual insured (co) who first diagnosed in hospital medical and health institutions, in principle, can choose to be hospitalized in designated medical institutions within the overall regional hospitals. In the urban districts with no secondary healthcare institutions, the actual insured (co) who needs to be transfer to the upper-level hospitals can select to be hospitalized in the designated medical institutions within the area according to the cross-level co-ordination.
　　Basic medical insurance for the rural and urban residents and new rural cooperative management set up different hospital deductibles and reimbursement system   according to the different levels of medical institutions to encourage and guide patients to receive a reasonable treatment. For the transferred patients the reimbursement rate of NCMS will be reduced by half and medi-care will not reimburse if the patient has no referral procedures but applying for the higher medical institution.
　　General specification referral for the public
　　Insured (co) personnel who has received the first diagnosis of medical treatment within the region can transfer to a higher hospital directly after the recognition of the doctor that there do exists a need for referral of his/her disease, first of all, the attending physician should fill out the "referral request form" in health care information platform, then, after the approval of the office of the new rural cooperative medical insurance or medical institutions can be agreed to delivered to the higher hospital according to the feedback information.
　　Patients with special medical needs should go to the doctor accompanied by his/her families or relatives, such as the old who is over 70 years, 0-3 years old infants and young children, patients with severe disabilities, and other high-risk pregnant women. They can choose the designated medical institutions for treatment according to "the nearest medical treatment" principle. Patients with diagnosed infectious disease must select specialist medical institutions as the first diagnosis of the medical institution and they will not be limited by the rate of referral. The special control of the initial diagnosis and referral of patients who has infectious diseases with suspected or confirmed should to performed in accordance with relevant provisions of the management of infectious diseases.
　　Insured (Co) patient working in other places within the city\'s overall regional insurances, college students studying in different places, the residents living in remote illness, should select the local medical institutions as the preferred location of the primary health care sector or medical institutions, Only by the recognition of the need for referral to a higher level of medical institutions special, acute danger, critically ill patients or in travel, tourism, visiting relatives on the way sudden acute danger, critically ill patients can be treated or hospitalized according to "the nearest medical treatment" principle. Patients or their families should inform the regional health insurance region or the new rural cooperative agencies within 72 hours, and the notice to the regional health insurance or a new IICA agencies and approval procedures should be filled and completed within seven working days from the families receiving the emergency medical certificate (or ill, dying).  (By Liu Jingjing, Chen Beilei and Pan Zhiming)