国家和广西分级诊疗相关政策分析
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摘要
目的分析国家和广西分级诊疗相关政策,探讨更为科学合理的政策建议。方法用比较分析法梳理国家和广西分级诊疗相关政策,对政策的完整性、协调性和可行性进行分析,提出相关建议。结果当前国家和广西的分级诊疗政策基本涵盖各级各类医疗机构功能定位、基层医疗卫生服务能力建设、医联体建设、家庭医生签约服务建设、医疗卫生信息化建设和组织保障6个方面内容,但仍存在医保支付政策缺位、部分政策协调性不高、可行性欠佳等问题。结论应尽快完善相关政策,建立政府主导、各部门协同化工作机制,优化医疗联合体及家庭医生签约服务建设,并解决基层医疗卫生机构诊疗项目和用药限制、医务工作者薪酬与医院业务收入关联性过大、部分政策概念模糊等问题。
Objective To analyze related national and Guangxi policies on hierarchical medical service,and explore more scientific and reasonable policy recommendations. Methods Related national and Guangxi policies on hierarchical medical service were sorted out by comparative analysis method,the integrity,coordination and feasibility of the existing policies were analyzed,and relevant suggestions were proposed. Results The current national and Guangxi policies on hierarchical medical service basically covered six aspects: the functional orientation of various types of medical institutions,the capacity building of primary medical and health services,the construction of medical alliances,the establishment of family doctor contract services,medical and health information construction,and organization guarantee. However,there still existed some problems,such as the absence of medical insurance payment policy,the low coordination of some policies,and poor feasibility. Conclusion It is necessary to improve related policies as soon as possible,establish a government-oriented and multi-departments-coordinated work mechanism,optimize the construction of medical alliances and family doctor contract services,and address the problems of medical treatment programs and drug restrictions in primary health care institutions,excessive relevance between the salary of medical workers and the income of hospital business,and blurred policy boundaries.
Objective To analyze related national and Guangxi policies on hierarchical medical service,and explore more scientific and reasonable policy recommendations. Methods Related national and Guangxi policies on hierarchical medical service were sorted out by comparative analysis method,the integrity,coordination and feasibility of the existing policies were analyzed,and relevant suggestions were proposed. Results The current national and Guangxi policies on hierarchical medical service basically covered six aspects: the functional orientation of various types of medical institutions,the capacity building of primary medical and health services,the construction of medical alliances,the establishment of family doctor contract services,medical and health information construction,and organization guarantee. However,there still existed some problems,such as the absence of medical insurance payment policy,the low coordination of some policies,and poor feasibility. Conclusion It is necessary to improve related policies as soon as possible,establish a government-oriented and multi-departments-coordinated work mechanism,optimize the construction of medical alliances and family doctor contract services,and address the problems of medical treatment programs and drug restrictions in primary health care institutions,excessive relevance between the salary of medical workers and the income of hospital business,and blurred policy boundaries.
引文
[1]饶克勤.健康中国战略与分级诊疗制度建设[J].卫生经济研究,2018(1):4-6,9.
[2]张彦生,王虎峰.基于分级诊疗的公立医院功能定位探究[J].中国卫生经济,2017,36(9):14-17.
[3]喻雪双,何文翀,屈伟,等.分级诊疗背景下基层医疗卫生机构基本医疗服务绩效考核指标体系探讨[J].现代预防医学,2018,45(3):467-470,495.
[4]张奕,卢东民,陈亚萍,等.我国各省市自治区的分级诊疗政策比较研究[J].中国全科医学,2018,21(10):1 167-1 176.
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[6]郑英,李力,代涛.我国部分地区分级诊疗政策实践的比较分析[J].中国卫生政策研究,2016,9(4):1-8.
[7]何文翀,周倩,谢冬玲,等.新形势下成都市医联体发展现状与思考[J].现代预防医学,2016,43(23):4 322-4 324.
[8]周晓梅,杨春松,林芸竹.国内分级诊疗现状的系统评价[J].中国药房,2017,28(34):4 763-4 766.
[9]顾掌生,翁艳艳.分级诊疗的瓶颈与路径[J].医院管理论坛,2015,32(12):13-16.
[10]徐志伟,张俊,秦成勇,等.分级诊疗双向转诊制度现状及政策分析[J].医院管理论坛,2018,35(3):11-14.
[11]王彤,赵岩,金光辉,等.北京市城区家庭医生式服务开展现况研究[J].中国全科医学,2015,18(28):3 413-3 416.
[12]吕键.论深化医改进程中分级诊疗体系的完善[J].中国医院管理,2014,34(6):1-3.
[13]佘瑞芳,朱晓丽,杨顺心.分级诊疗下基层医疗卫生机构的发展现状及建议[J].中国全科医学,2016,19(28):3 413-3 416.
[14]张慧林,成昌慧,马效恩.分级诊疗制度的现状分析及对策思考[J].中国医院管理,2015,35(11):8-9.
[15]傅书勇,杨悦.基于博弈论的我国分级诊疗制度分析与政策建议[J].中国医院管理,2018,38(2):24-25.
[2]张彦生,王虎峰.基于分级诊疗的公立医院功能定位探究[J].中国卫生经济,2017,36(9):14-17.
[3]喻雪双,何文翀,屈伟,等.分级诊疗背景下基层医疗卫生机构基本医疗服务绩效考核指标体系探讨[J].现代预防医学,2018,45(3):467-470,495.
[4]张奕,卢东民,陈亚萍,等.我国各省市自治区的分级诊疗政策比较研究[J].中国全科医学,2018,21(10):1 167-1 176.
[5]刘国恩,官海静.分级诊疗与全科诊所:中国医疗供给侧改革的关键[J].中国全科医学,2016,19(22):2 619-2 623,2 624.
[6]郑英,李力,代涛.我国部分地区分级诊疗政策实践的比较分析[J].中国卫生政策研究,2016,9(4):1-8.
[7]何文翀,周倩,谢冬玲,等.新形势下成都市医联体发展现状与思考[J].现代预防医学,2016,43(23):4 322-4 324.
[8]周晓梅,杨春松,林芸竹.国内分级诊疗现状的系统评价[J].中国药房,2017,28(34):4 763-4 766.
[9]顾掌生,翁艳艳.分级诊疗的瓶颈与路径[J].医院管理论坛,2015,32(12):13-16.
[10]徐志伟,张俊,秦成勇,等.分级诊疗双向转诊制度现状及政策分析[J].医院管理论坛,2018,35(3):11-14.
[11]王彤,赵岩,金光辉,等.北京市城区家庭医生式服务开展现况研究[J].中国全科医学,2015,18(28):3 413-3 416.
[12]吕键.论深化医改进程中分级诊疗体系的完善[J].中国医院管理,2014,34(6):1-3.
[13]佘瑞芳,朱晓丽,杨顺心.分级诊疗下基层医疗卫生机构的发展现状及建议[J].中国全科医学,2016,19(28):3 413-3 416.
[14]张慧林,成昌慧,马效恩.分级诊疗制度的现状分析及对策思考[J].中国医院管理,2015,35(11):8-9.
[15]傅书勇,杨悦.基于博弈论的我国分级诊疗制度分析与政策建议[J].中国医院管理,2018,38(2):24-25.