中国精神专科医院面临的住院服务压力和病人分流建议  

The challenges on inpatient service faced by psychiatric hospitals in China and a new system to effectively distributary patients

作　　者：罗力[1] 李伟 金春林[3] 蔡淳[3] 詹国芳[3] 项鸣涛 翁泽文[3] 贾妍 陈雯[3] 陈卓蕾[3] 刘芳[1] 舒蝶[1] 孔辉[1] 

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]上海市发展与改革委员会,上海200003 [3]上海市卫生局,上海200040

出　　处：《中国卫生政策研究》2011年第9期16-20,共5页Chinese Journal of Health Policy

基　　金：国家自然科学基金面上项目(71073027);上海市卫生局卫生政策研究基金项目(2009HP011)

摘　　要：分析了我国精神专科医院面临的住院服务压力,提出了相应的对策和建议:(1)随着医保制度的完善,精神疾病患者的住院服务需求将大量释放。(2)中国精神卫生服务的发展必然要经历一个精神专科医院床位扩增的阶段。短期内可增加床位配置,但弊端较多。(3)从长远看,应当立即着手建立精神专科医院病人分流机制,逐步提高精神专科医院的床位利用效率。病人分流的主要障碍是社区康复机构及专业人员不足,而且精神专科医院和社区康复机构缺乏利益纽带。(4)建议财政和残联负责建设社区康复机构,医保和残联补偿社区康复机构的运行成本,精神专科医院负责指导社区康复机构的工作。医保分类支付或者是按患者人数付费是建立病人分流长效机制的关键策略。In this paper,we predict the challenges on inpatient service faced by psychiatric hospitals in China and develop some policy recommendations.The results show that：（1） The inpatient service demand will increase greatly in the context of increasing insurance coverage.（2） The development of China＇s mental health services must go through a stage of psychiatric hospital beds amplification.More beds configured to temporarily meet the increasing need of mental inpatients in the short-term,however,it could be a drawback in the long-term.（3） In the long run,patient distributaries mechanism of psychiatric hospital should be established immediately to increase the bed utilization in psychiatric hospitals.The main barriers for distributaries are insufficient community rehabilitation and the poor interest bonds between psychiatric hospitals and community rehabilitation agencies.（4） We suggested that Financial Department of government and Disabled Persons＇ Federation are responsible for the construction of community rehabilitation agencies,Medical Insurance Department and Disabled Persons＇ Federation are responsible for the economic reimbursement of community rehabilitation agencies,and psychiatric hospital is responsible for guiding the operation of community rehabilitation agencies.Classification payment or pay for the number of patients should be applied in the economic reimbursement of psychiatric hospitals,which is a key strategy for long-term mechanism of patient distributaries.

关 键 词：精神卫生服务 住院服务 病人分流 

分 类 号：R197[医药卫生—卫生事业管理]