关键词: 社区首诊制, 转诊, 社区卫生中心

Abstract: The system for initial consultation in community-based healthcare settings is a key part of the hierarchical medical system.In Dongguan，the system for initial consultation in community-based outpatient clinics has been implemented since 2008.So far，it has obtained the following achievements：the mean annual workload shows an increasing trend during 2009 to 2016；the problem of "It is difficult and expensive to see a doctor" for residents has been addressed to some extent；the prevention and management of chronic diseases have been improved；the equity in healthcare use and healthcare efficiency have been enhanced.However，challenges such as significant differences in the operation status of this system across different towns（streets） of Dongguan，complicated referral procedures，high rate of referrals，intractable recruitment of health professionals and poor health workforce stability were identified.In order to promote the sustainable development of the system，we put forward the following measures：establishing community health centers in a unified manner，standardizing the referral standard for community-based outpatient clinics，developing scientific payment systems and promotion mechanisms for health professionals and guiding the residents to change the thought of seeking healthcare mostly in secondary or tertiary hospitals.

Key words: The system of the first treatment in the community, Referrals, Community health centers