医疗服务供需矛盾背景下中国医生集团发展模式与对策研究

发布时间：2019-04-22 09:45

【摘要】：随着我国老龄化进程的加快,医疗服务供需矛盾不断加剧,如何促进医疗资源的合理配置和有效利用,满足人们不断增长的医疗服务需求,成为医改的重大难题。人才的竞争是医疗市场竞争的根源,同样卫生人才也是攻克医改难题的重要因素。面对目前不同级别医院人力资源的差异,如何利用多点执业、分级诊疗政策来引导人力资源合理流动是解决中国医疗资源不平衡和人们日益增长的医疗需求这一矛盾的举措。此次课题以多点执业新政策为着眼点,针对医师多点执业的新现象—医生集团进行研究,目的是了解中国医生集团产生的背景,从政策、技术、社会等角度分析中国医生集团发展面临的复杂环境,通过中美两国医生集团发展现状的比较,明确不同医生集团的发展模式和特点,找到现阶段中国医生集团存在的问题,并针对问题提出可能的对策与建议,为未来中国医生集团的发展提供路径参考,进而为中国医改提供新的思路。医生集团是在当前医改进入瓶颈期后,医生从自身出发探索医改的新思路,在一定程度上对促进卫生人才的跨区域、跨地域合理流动,提高医疗资源的配置效率,解决中国医疗资源不平衡和人们日益增加的健康医疗需求之间的矛盾,更好为群众提供安全、有效、方便、价廉的医疗服有重要意义。此次研究运用文献法,对医生集团相关概念进行界定,梳理医生集团产生背景和发展环境;通过中美两国医生集团的对比研究,明确不同政策环境下医生集团各自的发展模式及特点;通过实证分析,以张强医生集团、大家医联、三甲医生集团为例重点分析中国医生集团现状、存在的问题、制约其发展的因素及未来发展对策,为未来医生集团的发展提供借鉴参考。目前国内对医生集团的研究主要是对个别医生集团现状的简单赘述,研究角度不够全面,研究内容不够深刻,研究方法也不够系统。笔者首次运用文献研究、对比研究、典型案例分析、归纳总结等多种方法对多个不同类型的医生集团进行系统研究,将中国的医生集团按照体制划分为体制内医生集团、体制外医生集团、平台型医生集团,按照发展特色划分为专科型和综合型医生集团。分析得出现阶段中国医生集团面临的主要挑战为现行人事制度的阻碍,内部运营与外部监管机制不明晰,品牌塑造缺乏群众基础,运营管理能力有待提高,医生集团受众有限,医师进入门槛高,盈利模式易于复制。对未来医生集团发展对策建议为推行医疗领域人事制度改革,完善医保支付体系,促进行业规范化,提升管理运营能力,促进行业信息共享,实现诊疗技术精细化。本研究拓宽了前人的研究思路,深化了对医生集团的横、纵面的系统研究,丰富了医生集团参与卫生服务供给的相关理论基础,完善了医生集团未来发展模式的体系架构,对后续的相关研究具有一定的启示和借鉴意义。
[Abstract]:With the acceleration of aging process in our country, the contradiction between supply and demand of medical services is becoming more and more serious. How to promote the rational allocation and effective use of medical resources and meet the growing demand for medical services has become a major problem in medical reform. Talent competition is the root of medical market competition, the same health personnel is also an important factor to overcome the difficult problems of medical reform. Facing the difference of human resources in different hospitals at present, how to use multi-practice and grade diagnosis and treatment policy to guide the reasonable flow of human resources is a measure to solve the contradiction between the imbalance of medical resources in China and the increasing medical demand of people. This subject focuses on the new multi-point practice policy, and studies the new phenomenon of doctors' multi-practice-the doctor group, in order to understand the background of the emergence of the Chinese doctor group, from the policy, the technology, From the angle of society and other aspects, this paper analyzes the complex environment facing the development of Chinese doctor group, through the comparison of the current development situation between China and the United States, clarifies the development mode and characteristics of different doctor groups, and finds out the problems existing in the present stage of Chinese doctor group. It also puts forward some possible countermeasures and suggestions for the future development of Chinese medical group, and then provides a new way of thinking for Chinese medical reform. Doctor group is a new way to explore medical reform from its own perspective after the current medical reform has entered the bottleneck period, to a certain extent, to promote the cross-regional, cross-regional rational flow of health personnel, and to improve the efficiency of the allocation of medical resources. It is of great significance to solve the contradiction between the imbalance of medical resources in China and the increasing demand for health care, so as to provide the masses with safe, effective, convenient and inexpensive medical clothes. This study uses the literature method to define the relevant concepts of doctor group, and to sort out the background and development environment of doctor group. Through a comparative study between China and the United States, the development patterns and characteristics of doctors' groups in different policy environments are clarified. Through empirical analysis, taking Dr. Zhang Qiang Group, Medical Association and three-member Medical Group as examples, this paper focuses on analyzing the current situation, existing problems, factors restricting its development and countermeasures for future development of China Doctor Group. To provide a reference for the future development of doctor group. At present, the research of doctor group in our country is mainly about the current situation of individual doctors group. The research angle is not comprehensive enough, the research content is not deep enough, and the research method is not enough systematic. For the first time, the author uses many methods, such as literature research, comparative study, typical case analysis, summary and so on, to systematically study many different types of doctors' groups, and divides the Chinese doctors' groups into within-system doctors' groups according to the system. Outside the system doctor group, platform type doctor group, according to the development characteristic divides into the specialized type and the comprehensive type doctor group. The main challenges faced by the Chinese doctors group in the emerging stage are the obstruction of the current personnel system, the unclear internal operation and external supervision mechanism, the lack of mass foundation for brand building, the need to improve the ability of operation and management, and the limited audience of the doctor group. Doctors have a high threshold for entry and the profit model is easy to replicate. The countermeasures for the future development of medical group are to carry out the reform of medical personnel system, perfect the payment system of medical insurance, promote the standardization of the industry, enhance the ability of management and operation, promote the sharing of information in the industry, and realize the fine technology of diagnosis and treatment. This research broadens the former research ideas, deepens the systematic research on the horizontal and vertical aspects of the doctors group, enriches the relevant theoretical basis of the doctor group's participation in the supply of health services, and consummates the system structure of the future development model of the doctor group. It has some enlightenment and reference significance to the follow-up related research.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1

【参考文献】