南宁市院前急救医疗服务供给的问题和对策研究

发布时间：2018-06-08 06:13

本文选题：院前急救 + 急救服务　；参考：《广西大学》2017年硕士论文

【摘要】：院前急救医疗服务体系由上世纪80年代发展至今已经有近30年历史。作为医疗服务体系中不可缺少的部分,院前急救医疗服务随着经济和医疗的发展而不断前进,从最简单的救护转运不断发展成为拥有独立机构、先进的指挥调度平台、专业人员、网络化管理的服务体系,为人民生命健康安全提供强有力的保障。2010年以来,院前急救医疗服务体系在原有基础上不断壮大,但是在前进的过程当中供需矛盾、服务方式落后等问题日益突出,与此同时,随着人民生活水平的提升,人民群众对院前急救医疗服务需求的数量、种类、水平也都相应发生了变化,传统的院前急救医疗服务模式所提供的服务远远不能满足人民群众的需求,因此,群众感觉“叫车难”、政府感觉“派车难”、各大医疗机构门前“黑救护车”泛滥等引发群众强烈关注的问题越演越烈,极大影响了人民群众的生命健康安全。新医改以来,国家不断出台相关政策,将院前急救医疗服务纳入基本公共卫生服务范畴,并实现人人享有的基本目标。研究院前急救医疗服务供给,创新院前急救医疗服务供给的模式和机制,对于加快基本医疗服务的发展,改善院前急救医疗服务“叫车难”、“派车难”、“黑救护车”等现象,推进城市应急和基础服务功能建设,促进社会和谐发展有着重要的意义。本文认为,院前急救医疗服务供给总量的不足不仅是院前急救医疗服务总量不足的问题,更核心的是服务供需结构失衡的问题。在我国,院前急救医疗服务供给主体单一、政府权责不清、人才培养体系不合理等原因是造成院前急救服务市场供不应求的根本原因。本文分四个部分进行阐述:第一部分主要阐述我国急救医疗服务的历史发展与现况,并对南宁市院前急救医疗服务的现况进行分析,找出存在的问题和产生的原因。第二部分主要阐述公共产品的定义和分类及其供给模式,分析了院前急救医疗服务的准公共产品性质及南宁急救医疗服务有效供给不足与其准公共产品性质的关系,提出院前急救医疗服务采取混合供给的优势和必要性。第三部分通过对美国、英国等先进国家院前急救医疗体系的构成、资金来源、人才培养的特点进行阐述,总结出值得我国院前急救医疗服务体系借鉴的经验和做法。第四部分在借鉴国外先进做法和经验的基础上,结合公共产品的供给理论,提出应该构建院前急救医疗服务分类供给、急救人才分层次培养的机制,以扩大我国院前急救医疗服务的有效供给。本文研究的意义在于探索一个以统筹各级医疗资源优化配置、降低服务成本、构筑多元化平台、提高院前医疗服务有效供给,且符合院前急救医疗发展趋势、群众满意的院前急救医疗供给体系,以有效解决我国“看病难、看病贵”的民生问题,推进我国基本医疗体系的发展和完善。
[Abstract]:The system of pre-hospital emergency medical service has been developed for nearly 30 years since 1980's. As an indispensable part of the medical service system, the pre-hospital first aid medical service continues to advance with the development of economy and medical treatment, from the simplest ambulance transshipment to the advanced command and dispatch platform with independent organization. Professional personnel, the service system of networked management, provides a strong guarantee for the life, health and safety of the people. Since 2010, the pre-hospital emergency medical service system has been growing on the basis of the original, but in the process of progress, there is a contradiction between supply and demand. The problems of backward service methods have become increasingly prominent. At the same time, with the improvement of the people's living standards, the number, type and level of the people's demand for pre-hospital emergency medical services have changed accordingly. The services provided by the traditional pre-hospital emergency medical service model are far from meeting the needs of the masses. Therefore, the masses feel that it is difficult to call a car, and the government feels that it is difficult to send a car. The proliferation of "black ambulances" in front of major medical institutions and other issues that have aroused people's intense concern has greatly affected the lives, health and safety of the people. Since the new medical reform, the state has constantly issued relevant policies to bring pre-hospital emergency medical services into the category of basic public health services, and to achieve the basic goal of everyone. The supply of pre-hospital emergency medical service and innovation of the mode and mechanism of pre-hospital emergency medical service supply can accelerate the development of basic medical service, improve the pre-hospital emergency medical service "car call difficulty", "dispatch car difficulty", It is of great significance to promote the construction of urban emergency and basic service function and to promote the harmonious development of society. This paper holds that the shortage of the total supply of pre-hospital emergency medical services is not only the problem of the shortage of the total amount of pre-hospital emergency medical services, but also the imbalance of the supply and demand structure of the services. In our country, the main supply of pre-hospital emergency medical service is single, the government's power and responsibility are not clear, and the personnel training system is unreasonable. This paper is divided into four parts: the first part mainly expounds the historical development and present situation of the first aid medical service in our country, and analyzes the present situation of the pre-hospital emergency medical service in Nanning City, and finds out the existing problems and causes. The second part mainly expounds the definition and classification of public goods and its supply mode, analyzes the nature of quasi-public goods of pre-hospital emergency medical service and the relationship between the shortage of effective supply of Nanning emergency medical service and the nature of quasi-public goods. The advantages and necessity of mixed supply of pre-hospital emergency medical service were put forward. The third part expounds the constitution, the source of funds and the characteristics of personnel training of the pre-hospital first aid medical system in the United States, Britain and other advanced countries, and sums up the experience and practice that our country's pre-hospital emergency medical service system can use for reference. In the fourth part, on the basis of drawing lessons from foreign advanced practices and experience and combining the supply theory of public goods, the author puts forward that the mechanism of classified supply of pre-hospital emergency medical service and training of emergency personnel should be constructed. In order to expand the effective supply of pre-hospital emergency medical services in China. The significance of this study is to explore an optimal allocation of medical resources at all levels, to reduce service costs, to build a diversified platform, to improve the effective supply of pre-hospital medical services, and to accord with the development trend of pre-hospital emergency medical care. The supply system of pre-hospital emergency medical treatment is satisfied by the masses in order to effectively solve the livelihood problems of "difficult to see a doctor, expensive to see a doctor", and to promote the development and improvement of the basic medical system of our country.
【学位授予单位】：广西大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R459.7

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