我国县域分级医疗服务体系构建现状研究

发布时间：2018-09-17 20:00

【摘要】：目的调查分析县域分级医疗服务体系构建及运行现状,挖掘影响分级医疗的不利因素,提出推进对策。方法抽样调查全国11个国家级公立医院改革试点县县域内医疗资源和服务量的布局、患者就诊流向、医药费用及医保支出等情况,采用描述性统计方法、文献分析等方法对现况进行剖析。结果县域分级医疗体系基本构建,但基层医疗机构人力资源配置待优化,医疗资源利用效率、服务能力不高,医保控费效果不显著,群众就医理念待更新,基层首诊、双向转诊、分级医疗运行状况不佳。结论实现分级医疗应从优化县域医疗服务体系结构着手,优化县域资源配置,制订双向转诊标准,提升基层医疗机构服务能力,加强健康教育,构建高效运转的县域分级医疗服务体系。
[Abstract]:Objective to investigate and analyze the present situation of the construction and operation of the hierarchical medical service system in county area, to excavate the unfavorable factors affecting the classified medical treatment, and to put forward the countermeasures to promote it. Methods A sample survey was carried out on the distribution of medical resources and services, the direction of patients' visits, medical expenses and medical insurance expenditures in 11 national public hospital reform pilot counties, and descriptive statistical methods were used. Literature analysis and other methods to analyze the current situation. Results the county level medical system was basically constructed, but the allocation of human resources in primary medical institutions needed to be optimized, the utilization efficiency of medical resources was not high, the service capacity was not high, the effect of medical insurance and control fees was not significant, the idea of mass medical treatment was to be updated, and the first consultation at the grass-roots level was needed. Two-way referral, graded medical operation is not good. Conclusion the realization of classified medical treatment should begin with optimizing the system structure of medical service at county level, optimize the allocation of resources in county area, formulate the standard of two-way referral, enhance the service ability of primary medical institutions, and strengthen health education. Build an efficient county-level medical service system.
【作者单位】：中山大学附属第一医院;潍坊市卫生和计划生育委员会;华中科技大学同济医学院医药卫生管理学院;
【基金】：原卫生部医改办委托项目“加强医疗服务机构监管策略研究” 广东省科技计划项目(2011B060500043) 广东省医学科学技术基金(B2014067)
【分类号】：R197.1

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