医联体制度下患者就医模式转变的困境与应对策略
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摘要
目的:探讨当前医联体运行模式下,患者就医模式转变的困境,并为其提供合理建议。方法:在分析患者就医选择影响因素的基础上,理清医联体与患者就医模式的关系,找出医联体在促进患者就医模式转变方面的不足。结果:由于目前各地医联体内部存在利益分配机制不明晰、医保政策不健全、行政管理体制尚不完善等问题,在很大程度上影响了患者分层次就医的目标实现。结论:实现医联体从松散型向紧密型运作模式的转变,最大程度地实现医联体内部人、财、物资源的统一和综合管理是转变患者就医模式的关键。
Objectives: To explore the dilemma of the patients' change in the mode of seeking medical treatment under healthcare alliances and provide coping strategy. Methods: Based on the analysis of the influence factors of the patient's medical treatment choice, the relationship between the medical alliance and the patient's medical care model was clarified. And the weakness of medical alliance mode on guiding patient visiting choice has been found out. Results: The ambiguous of interest sharing mechanism, incompletion medical insurance payment and administration system mostly caused hierarchical medical system effective implementation. Conclusions: The key points of guiding patient visiting choice are changing medical alliance operation mode from loose management to integrated human resource, material and finance management. The body of healthcare alliances in china is limited in patients' medical choice, such existing problems as the unclear profit distribution mechanism, the imperfect medical insurance policy, and unimproved healthcare administrative system. Conclusions: It is the key to solve the problem to realize the transformation from a loose type to a close medical operation mode and to realize the unification and comprehensive management of the human, financial and material sources within the medical association as much as possible.
Objectives: To explore the dilemma of the patients' change in the mode of seeking medical treatment under healthcare alliances and provide coping strategy. Methods: Based on the analysis of the influence factors of the patient's medical treatment choice, the relationship between the medical alliance and the patient's medical care model was clarified. And the weakness of medical alliance mode on guiding patient visiting choice has been found out. Results: The ambiguous of interest sharing mechanism, incompletion medical insurance payment and administration system mostly caused hierarchical medical system effective implementation. Conclusions: The key points of guiding patient visiting choice are changing medical alliance operation mode from loose management to integrated human resource, material and finance management. The body of healthcare alliances in china is limited in patients' medical choice, such existing problems as the unclear profit distribution mechanism, the imperfect medical insurance policy, and unimproved healthcare administrative system. Conclusions: It is the key to solve the problem to realize the transformation from a loose type to a close medical operation mode and to realize the unification and comprehensive management of the human, financial and material sources within the medical association as much as possible.
引文
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[2]刘婷婷,林琳,夏令国,等.国内区域医疗联合体的研究现况与述评[J].卫生软科学,2016,30(6):5-9.
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[4]魏敏,肖锦铖.患者就医选择的影响因素及对策分析[J].中国卫生事业管理,2014,31(4):259-261.
[5]刘庆,王清亮,费剑春,等.我国医疗联合体主要运行模式及存在的问题[J].中国医院管理,2017,37(9):33-35.
[6]郑蕾.医疗联合体推动分级诊疗作用有限[J].中国卫生经济,2017,36(9):18-19.
[7]任飞.完善区域纵向医联体建设的思考——基于制度理性选择框架[J].中国卫生政策研究,2016,9(10):1-5.
[8]孙涛,张淑娥,吴群红,等.区域医疗联合体发展困境的多级递阶结构与逻辑阐释[J].中国医院管理, 2017,37(3):31-33.
[9]吴洪涛,黄长久.我国区域纵向型医联体发展现状及政策建议[J].中华医院管理杂志,2017,33(8):561-564.
[10]李念念,赵允伍,尹红艳,等.医联体发展困境与策略浅析[J].中国卫生事业管理,2017,34(8):561-562.
[11]赵芳,甄天民,谷景亮,等.我国发展区域医疗联合体的SWOT分析[J].卫生软科学,2014,28(6):339-342.
[12]杨立成,鲍琳辉,田义娟,等.医联体模式下构建双向转诊机制的探讨[J].中国医院,2015,19(07):33-35.
[13]杜红波,从紫薇,邹小明.区域医联体顶层设计的思考[J].现代医院管理,2017,15(5):15-17.
[14]王成.构建以制度建设为核心的医联体管理体系[J].卫生经济研究,2016,33(9):17-19.
[15]黄庆辉,胡敏.医联体建设的模式分析和国际经验借鉴[J].中国医院,2015,19(10):56-59.
[2]刘婷婷,林琳,夏令国,等.国内区域医疗联合体的研究现况与述评[J].卫生软科学,2016,30(6):5-9.
[3]陈饶,杜旭东,杨展,等.成都市门诊就诊患者就医选择及影响因素分析[J].现代预防医学,2016,43(22):4217-4220.
[4]魏敏,肖锦铖.患者就医选择的影响因素及对策分析[J].中国卫生事业管理,2014,31(4):259-261.
[5]刘庆,王清亮,费剑春,等.我国医疗联合体主要运行模式及存在的问题[J].中国医院管理,2017,37(9):33-35.
[6]郑蕾.医疗联合体推动分级诊疗作用有限[J].中国卫生经济,2017,36(9):18-19.
[7]任飞.完善区域纵向医联体建设的思考——基于制度理性选择框架[J].中国卫生政策研究,2016,9(10):1-5.
[8]孙涛,张淑娥,吴群红,等.区域医疗联合体发展困境的多级递阶结构与逻辑阐释[J].中国医院管理, 2017,37(3):31-33.
[9]吴洪涛,黄长久.我国区域纵向型医联体发展现状及政策建议[J].中华医院管理杂志,2017,33(8):561-564.
[10]李念念,赵允伍,尹红艳,等.医联体发展困境与策略浅析[J].中国卫生事业管理,2017,34(8):561-562.
[11]赵芳,甄天民,谷景亮,等.我国发展区域医疗联合体的SWOT分析[J].卫生软科学,2014,28(6):339-342.
[12]杨立成,鲍琳辉,田义娟,等.医联体模式下构建双向转诊机制的探讨[J].中国医院,2015,19(07):33-35.
[13]杜红波,从紫薇,邹小明.区域医联体顶层设计的思考[J].现代医院管理,2017,15(5):15-17.
[14]王成.构建以制度建设为核心的医联体管理体系[J].卫生经济研究,2016,33(9):17-19.
[15]黄庆辉,胡敏.医联体建设的模式分析和国际经验借鉴[J].中国医院,2015,19(10):56-59.