区域医疗联合体在杭州市拱墅区发展的问题研究

发布时间：2018-03-25 19:25

本文选题：医疗联合体　切入点：基本医疗卫生服务　出处：《安徽大学》2014年硕士论文

【摘要】：生命健康权是不会因为种族、年龄、性别、经济水平和社会地位等方面的差异而存在高低贵贱之分,它是人类最基本的一项人权,也是人类享有其他各种权利的基础。为了保障人人都能获得基本的生命健康权,国家一直都在致力于医疗卫生服务体系建设。现阶段,医疗卫生事业随着我国经济水平大幅提高有了较大的发展,而医疗技术水平也得到了明显提升。然而由于多种原因,目前“看病难,看病贵”,医患关系紧张,城市大医院看病患者熙熙攘攘、人满为患,而在基层社区医院求医问药者冷冷清清的现象仍然十分严重。2009年4月6日中央政府发布的,中共中央、国务院在《关于深化医药卫生体制改革的意见》明确指出：要完善以社区卫生服务为基础的新型城市医疗卫生服务体系,建立城市大医院与社区卫生机构的分工合作机制。由此从政策层面,国家给出了下一步医疗卫生体制改革的目标,也为建立全民享有的基本医疗卫生制度、渐进有序地达到人人享有的最基本医疗卫生服务这一战略目标指明了方向。同时新型城市医疗卫生服务体系的建立,有利于缓解目前困扰人们看病难、看病贵的社会现状,缩小社会成员的城乡差距和群体差异；有利于促进区域经济发展,保持社会稳定和谐；更有利于全社会早日实现伟大的“中国梦”。然而,在构建新型城市医疗卫生服务体系的过程中,如何促进城市大医院与社区卫生服务机构之间的分工协作?几级医疗机构采取哪种协作方式?杭州市拱墅区卫生局与杭州师范大学附属医院组建了医疗联合体,为建立新型城市医疗卫生服务体系进行了大胆的探索。本文综合了国内外医疗联合体发展水平,系统的介绍了拱墅区医联体的建立和发展,以及在发展的过程中存在的问题,剖析了存在的问题原因,提出了相应的解决方法。文章一共有五个章节。第一章为绪论,提出了论文的选题及其目的、主要概念,包括公共产品、基本医疗卫生服务、政府主导和医疗联合体等概念的界定及其相关阐述、提出了主要观点和研究方法以及本文可能的创新和不足之处等。第二章为文献回顾,包括医疗联合体在国外发展和医疗联合体在国内发展现状。医联体在国外发展,主要介绍了在美国、英国、德国、巴西和印度等国发展的现状；医联体在国内发展,主要介绍了在北京、上海、湖北、江苏镇江和河南等地发展的现状。第三章为医疗联合体在杭州市拱墅区的发展的现状,介绍了医疗联合体在杭州拱墅区的建立、发展的现状、发展和运行中存在的问题。第四章为医疗联合体在杭州市拱墅区发展存在问题的原因分析,包括内部协调不够的原因分析、信息化建设存在问题的原因分析、病人在双向转诊中存在问题的原因分析等。第五章为对存在问题的提出对策和建议。本文认为要构建新型城市医疗卫生服务体系,建立区域医疗联合体,应该由政府主导,统筹规划,建立各级医疗卫生机构的协作整合机制；要建立利益平衡机制,引导卫生系统各种资源共享；政府和各级医疗机构应加大宣传力度,让老百姓能理解和支持这项改革措施；同时要加快信息化建设,为区域医疗联合提供信息保障等四个方面进行综合考虑。
[Abstract]:The right to life and health is not because of race, age, gender, differences in economic level and social status of the high and low points, it is one of the most basic human rights, is the basis of human rights to any other. In order to ensure everyone can obtain the basic rights of life and health, countries are working in the construction of medical and health service system. At present, the medical and health undertakings along with our country economy to a substantial increase in the level of a larger development, but the level of medical technology has been improved significantly. However, due to various reasons, the current "disease difficult, expensive, tense doctor-patient relationship, city hospital doctor patient overcrowding, streams of people busily coming and going. The Central Committee of the Communist Party at the grassroots community hospital doctor who desolate phenomenon is still very serious.2009 year in April 6th the central government issued the State Council," on deepening the medical and health Reform opinions clearly pointed out: to improve the community health service of new city based medical and health service system, establish the cooperation between city hospital and community health institutions. From the policy level, the state gives the health system reform in the next goal, but also to establish a basic medical and health care system for people to enjoy the and gradually achieve the strategic goal of the basic medical and health services for all the direction. At the same time to establish a new city health service system, help to alleviate the troubled people see disease difficult, expensive medical social situation, the gap between urban and rural areas and narrow the gap between groups of members of society; is conducive to promoting regional economic development. To maintain social stability and harmony; more conducive to the early realization of the great "China dream" of the whole society.
However, in the process of constructing the new city health service system, how to promote city hospital and community health service institutions of the division of labor? A few medical institutions take what kind of cooperation? The Affiliated Hospital of Hangzhou Gongshu District City Health Bureau and Hangzhou Normal University set up a Medical Association, made a bold exploration for the establishment of the new city health service system. This paper describes the development level of domestic and International Medical Association, introduced the system of the establishment and development of Gongshu District Medical Association, as well as the problems existing in the process of development, and analyzes the causes of existing problems, puts forward corresponding solving methods.
This paper consists of five chapters. The first chapter is the introduction, put forward the topic and purpose, the main concepts, including public goods, basic medical and health services, and define the government leading medical association and its related concepts such as paper, put forward the main ideas and research methods and the possible innovations and deficiencies. The second chapter is the literature review, including the current situation in the domestic development of the Medical Association in the development of foreign and Commonwealth. Medical conjoined development in foreign countries, mainly introduced in the United States, Britain, Germany, Brazil and India and other countries in the development of the status quo; conjoined in domestic development, mainly introduced in Beijing, Shanghai, Hubei, the status quo Jiangsu, Zhenjiang and Henan and other places of development. The third chapter is the present development of Hangzhou Medical Association in Gongshu District City, the establishment of the Medical Association in Hangzhou, Gongshu District, the development of the status quo, development and operation For the existing problems. The fourth chapter is the analysis of the Medical Association in Hangzhou city Gongshu District cause development problems, analysis of reasons including internal lack of coordination, analysis of the problems of informatization construction, the problems existing in the two-way referral of patients in the analysis of the causes. The fifth chapter is the problems and put forward countermeasures and suggestions.
This paper argues that in order to build a new city health service system, the establishment of regional medical consortium, to be led by the government to co-ordinate the planning, establishment of cooperation mechanism of medical and health institutions at all levels; to establish the mechanism of balancing of interests, guiding the various resources sharing health system; the government and medical institutions at all levels should intensify propaganda, so that people can understand and support the reform measures; at the same time to speed up the construction of information technology for Regional Medical Association four aspects of information security such as a comprehensive consideration.

【学位授予单位】：安徽大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R197.1

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