In February 2008 the Xiamen Municipal Government reorganized the health service in Xiamen City to create a"Xiamen Model"for community health service.The community health service centers were divided into two parts:the public health service was directly undertaken by the loal government,and the medical service was affiliated to one of the tertiary hospitals.Both were financed by govemment budget,but operated separately.A recent survey showed that the "Xiamen model" promoted the vertical integration of Xiamen medical resources.increased the service efficiency,reduced the medical and drug cost,and improved the satisfaction of local residents.Nevertheless,there were still some problems;the tertiary hospital should change its service pattern and enhance general practice in the community,the finance compensating mechanism need to be improved.

During 2004 to 2009, 701 patients with diabetes were under community-hospital-based integrated management at Zhonghua and Xiagang community health-care service centers, Xiamen, Fujian.Changes of clinical indicators, life-style and frequency of checks for its complications in them were compared before and after the management. All clinical indicators decreased with length of management, with fasting blood glucose from ( 7. 6 ± 2. 3 ) mmol/L before management to ( 7. 3 ± 2. 0) mmol/L half a year after management, (7. 2 ± 2. 1 ) mmol/L one year after management, (6. 9 ± 1.7 ) mmol/L two years after management. Their life-style also improved significantly and frequency of checks for complications increased with: 54. 4% for retinopathy, 52. 5% for diabetic foot, and 51.8% for neuropathy after management (P ＜0. 05).

A "Three-in-One" model of family doctor contract service was proposed in July 2014 and then implemented in Xiamen.In this model the health service was provided to contracted residents by a team consisted of specialists from tertiary hospitals , general practitioners and health manager in community health service centers.After the implementation of the model , the proportion of visiting in primary care institutions among the residents surpassed that in hospital visiting ,appearing a inflection point .The satisfaction of the residents increased significantly , meanwhile the income of primary care medical staff increased substantially and the position of primary care seemed to be more attractive .The "Three-in-One" service model of Xiamen may provide valuable experiences for implementation of family doctor contract service and hierarchichal medical service system in other areas of China .

Objective To estimate the application value of a standard operating procedure (SOP) in the detection of syphilitic anticardiolipin reagin. Methods Clinical laboratories from 9 local hospitals in Shanghai participated the program. Quality control samples with unknown target value were qualitatively and quantitatively examined according to the uniform SOP in these laboratories with the same reagent and facility of horizontal reaction. External quality assessment (EQA) was carried out by using seven serum samples with no, or low (1∶ 128 dilution) to high (1∶1 dilution) concentrations of target before and after the implementation of SOP. The test results were statistically analyzed and the reasons for the detecting error were assessed. Results A total of 388 tests were performed in the 9 clinical laboratories. The total accuracy rate was 93.0%, including 40.2% in the detection of samples with 1 ∶ 8 dilution of target, 49.2% in the detection of samples with 1 ∶ 16 dilution of target, and 3.6% in the detection of samples with 1 ∶ 32 dilution of target. No forward bias was observed in these tests. There was a significant difference in the accuracy rate between the two times of EQA before and after the implementation of SOP (x2 = 4.17, P < 0.05). Conclusions The improved standard procedure for nontreponemal antigen test is beneficial to the decrease of testing error, and may provide a basis for the establishment of SOP and implementation of internal quality assessment.