分级诊疗模式下X镇卫生院发展战略研究

发布时间：2018-03-14 00:54

本文选题：分级诊疗　切入点：医联体　出处：《西南交通大学》2017年硕士论文　论文类型：学位论文

【摘要】：随着新医改的实施,医疗保险实现了全面覆盖,人民群众的医疗卫生需求被大量释放。各类医疗卫生机构迅速发展,民营医院数量显著增加,病员和医生更多地聚向了城市大医院,但乡镇卫生院却出现了萎缩的迹象,其机构数量、服务数量和服务占比不增反降,这违背了医疗改革的初衷。在大型医院依然存在着"看病难、看病贵"问题的同时,乡镇卫生院的人力和设备却闲置浪费。2015年,国家全面推行分级诊疗制度,希望通过"基层首诊、双向转诊、急慢分治和上下联动"等措施将医疗资源向基层引导,旨在建立合理的就诊秩序。国家将采取一系列医疗、医保、人事等政策将患者、医务人员、诊疗行为留在县域范围内的基层医疗机构。对于乡镇卫生院来说,这既是前所未有过的发展机会,但也面临着严峻的挑战。在此轮医疗卫生资源下沉过程中,乡镇卫生院若未能顺势提高市场占有率,具有比较优势的县级医疗机构将因获得更多的下沉资源而更具竞争力,届时乡镇卫生院的生存和发展将比当前更加困难。面对机会与挑战并存的外部环境,乡镇卫生院必须要预判未来趋势,找准定位,制定合理的规划,主动适应这种变革,努力抓住机会,避开挑战,方能平稳度过艰难的变革期并谋求长远的发展。本文以X镇卫生院为对象,对内外部环境进行了全面梳理和分析探讨。首先通过PEST分析法对政治、经济、社会、文化以及科技等宏观环境进行了分析,并针对当前倍受重视的"生态文明建设"对医疗机构的影响进行了创新性探索,运用波特"五力"分析模型对行业竞争格局进行了研究,同时还针对当前分级诊疗模式下医疗机构间的竞争合作关系进行了创新性探讨,最后对X镇卫生院内部财务状况、服务能力、服务效率、营销能力和组织效率进行了综合性分析。通过梳理总结出了该机构所面临的10项机会和8项威胁,以及其所具备的6项优势和9项劣势。根据SWOT分析和分级诊疗制度等国家政策为该机构理清了使命、宗旨和目标,通过SWOT态势分析法就X镇卫生院应该如何运用自身的优势去抓住外部机会,又该怎样改善自身的劣势避免威胁等问题做出了创新发展的战略选择,并制定了具体的战略实施方案和实施过程中的控制预案。最后,对该机构战略实施效果进行了阶段性评估,进一步认为在战略实施初期,管理者应重点关注并督导战略方案的执行,以确保战略目标的最终实现。
[Abstract]:With the implementation of the new medical reform, medical insurance has been fully covered, and the mass medical and health needs of the people have been released in large quantities. Various kinds of medical and health institutions have developed rapidly, and the number of private hospitals has increased significantly. More patients and doctors have gathered to major urban hospitals, but township hospitals have shown signs of shrinking, with the number of institutions, the number of services and the proportion of services falling rather than increasing. This goes against the original intention of health care reform. While the problem of "difficult and expensive to see a doctor" still exists in large hospitals, the manpower and equipment of township health centers are idle and wasted. In 2015, the state comprehensively implemented the hierarchical diagnosis and treatment system. It is hoped that medical resources will be directed to the grass-roots level through such measures as "first diagnosis at the grass-roots level, two-way referral, acute and slow separation and linkage between the upper and lower levels." the aim is to establish a reasonable medical order. The state will adopt a series of policies such as medical care, medical insurance, personnel and other policies to bring patients to the primary level. Medical personnel, the primary medical institutions whose diagnosis and treatment behavior remains within the county scope. For township health centers, this is not only an unprecedented opportunity for development, but also a serious challenge. In the course of this round of medical and health resources sinking, If township health centers fail to increase their market share, county-level medical institutions with comparative advantages will be more competitive because they have more sinking resources. At that time, the survival and development of township health centers will be more difficult than at present. In the face of the external environment where opportunities and challenges coexist, township health centers must anticipate future trends, find a correct orientation, formulate reasonable plans, and actively adapt to this kind of change. Only by seizing the opportunity and avoiding the challenge, can we smoothly pass the difficult period of change and seek long-term development. This paper, taking the X Township Health Center as the object, comprehensively combs and analyzes the internal and external environment. Firstly, through the PEST analysis method, we analyze the politics, The macro environment, such as economy, society, culture and science and technology, is analyzed, and the influence of "ecological civilization construction", which has been paid more attention to, on medical institutions has been explored innovatively. Using Porter's "five forces" analysis model to study the competition pattern of the industry, at the same time, aiming at the innovative relationship of competition and cooperation among medical institutions under the current classified diagnosis and treatment mode, finally, the financial situation of X Township Health Center is discussed. Comprehensive analysis of service capability, service efficiency, marketing capability and organizational efficiency. By sorting out 10 opportunities and 8 threats to the organization, As well as its 6 strengths and 9 disadvantages. According to the national policies such as SWOT analysis and hierarchical diagnosis and treatment system, it clarifies the mission, purpose and goal of the organization. Through the analysis of SWOT situation, the paper makes a strategic choice of how to make use of its own advantages to seize external opportunities and how to improve its inferiority to avoid threats, and so on. Finally, the paper evaluates the effect of the strategy implementation in stages, and further thinks that in the early stage of the strategy implementation, Managers should focus on and oversee the implementation of strategic programs to ensure the ultimate achievement of strategic objectives.
【学位授予单位】：西南交通大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.62

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