Study on the current situation of the diagnosis and treatment of specialist diseases by general practitioners in Shanghai

Objective To understand the current situation of general practitioners' diagnosis and treatment of specialized diseases in Shanghai Community Health Service Center by means of questionnaire survey, and to provide direction for the continuing education of community general practitioners in order to improve the clinical quality of community general medicine and further promote the development of general medicine. Methods In November 2018, the administrators of 244 community health service centers and 4 047 general practitioners working in community health service centers were distributed through the questionnaire star network using a self-designed questionnaire. Results The proportion of doctors in ophthalmology(62.82% vs. 33.13%, P<0.05) and otolaryngology(60.26% vs. 30.12%, P<0.05) in urban areas was higher than that in suburbs, and the proportion of pediatricians in suburbs was higher than that in urban areas(34.94% vs. 20.51%, P<0.05). The referral rates of otorhinolaryngologic diseases(56.15% vs. 51.87%), paediatric diseases(81.46% vs. 66.60%), dermatology diseases(23.83% vs. 19.08%) in urban areas were higher than those in suburban areas(all P<0.05), while the referral rate of gynecological diseases in suburb was higher than that in urban area(79.40% vs.74.61%, P<0.05). The proportion of services provided by urban general practitioners was higher than that provided by suburban general practitioners in chronic disease management appointments(82.55% vs. 77.47%, P<0.05), psychological counseling(73.83% vs. 66.45%, P<0.05) and nutritional counseling(72.59% vs. 61.57%, P<0.05). Conclusion General practitioner of Shanghai Community Health Service Center have urban-rural differences in the diagnosis and treatment behavior of specialized diseases, which may be due to the difference in the proportion of specialized doctors, the lack of confidence in the ability of diagnosis and treatment of specialized diseases, and the uneven distribution and development of health resources. In the future, the contents of related specialized diseases should be add to the continuing education of community general practitioners.