英美澳整合型医疗服务系统的演进逻辑与借鉴  

Evolution logic of integrated medical delivery system in the UK, the USA and Australia and lessons to learn

作　　者：魏来[1] 刘国琴[1] 刘岚 叶婷[3] 张亮[3] 

机构地区：[1]遵义医学院管理学院,563003 [2]贵州省卫生厅农卫处 [3]华中科技大学同济医学院医药卫生管理学院

出　　处：《中华医院管理杂志》2014年第5期396-400,共5页Chinese Journal of Hospital Administration

基　　金：教育部人文社会科学规划基金资助项目（71273099）

摘　　要：医疗服务系统整合遵循制度创新和发展的逻辑.英、美、澳三国的案例研究发现,各国医疗系统整合都是本国一系列混杂因素影响的结果.筹资和医保支付机制改革、医师团队建设、保健服务的阶梯式下沉、共享的临床规范运用以及渐进式发展等,构成了服务整合的一般逻辑.在演进过程中,政府与市场、公平与效率的权衡一直贯穿整合进程.基于以上演进逻辑,我国推进医疗服务系统整合应该加快整合理念转变,完善整合要素建设,加强整合规律指导.Medical service system integration follows the logic of system innovation and development. Case studies of the UK, the USA and Australia found that medical delivery system integration is the product of a series of mixed factors. Health care financing and payment mechanism reform, physician team building, stair-cased movement to grassroots of healthcare service, shared clinical norms utilization as well as its gradual development constitute the general logic of such an integration. In the evolution process, the check and balance between the government and market, equity and efficiency have been affecting the integration process all the way. In light of these logics, China should speed up its transform of the integration concept, improve the integration elements, and strengthen the guidance of integration principles during its integration of the medical service integration.

关 键 词：整合型医疗服务系统 整合 动因 规律 

分 类 号：R199[医药卫生—卫生事业管理]