上海市松江区分级诊疗问题分析和政策建议  

Hierarchical Medical Service in Songjiang District in Shanghai:Problem Analysis and Policy Recommendations

作　　者：江一峰[1] 万文[1] 段茗玉[1] 冯运[1] 

机构地区：[1]上海交通大学附属第一人民医院,上海200080

出　　处：《中国卫生质量管理》2017年第1期81-83,共3页Chinese Health Quality Management

基　　金：上海市卫计委2015年度卫生政策自选课题(2015HP031)

摘　　要：目的分析目前推行分级诊疗制度存在的主要问题与矛盾,并结合社区居民的现况调研,提出推行分级诊疗制度的政策建议。方法以卫生政策和医院管理专家为对象进行深入访谈,以不同级别医院管理人员为对象进行小组访谈,记录、收集访谈资料,并根据访谈提纲进行分解、归纳与整理。结果目前推行分级诊疗制度存在就诊强制措施刚性不足,社区医院医疗水平不高,以及三级医院绩效考核和规模发展压力等问题。结论推行分级诊疗制度应进一步明确各级医院功能定位,提高社区医院医疗水平,畅通各级医院转诊通道,并通过设立区域诊疗检查中心,以老年人为突破口,以慢性病为切入点逐步推进。Objective To analyze the major problems and contradictions of hierarchical medical system, and make policy recommendations on the system based on the current situation investigation on community residents. Methods In--depth interviews were carried out with health policy and hospital management experts, as well as group interviews with managers from different levels in hospital. Interview data were recorded, collected, then summed up and organized according to the interview outline. Results In implementing the hierarchical medical system, the major problems were insufficient rigidity of medical compulsory measures, low medical level of community hospitals, performance appraisal and scale development pressure of tertiary hospitals. Conclusion To implement hierarchical medical system, function orientation of all levels of hospitals should be further defined, the medical level of community hospitals should be improved, the referral channel among hospitals should be unblocked. Furthermore, the hierarchical medical system should be implemented gradually through building the regional medical examination center with aged people as breakthrough and chronic diseases as pointcut.

关 键 词：分级诊疗 现况调研 社区医院 三级医院 政策建议 

分 类 号：R197[医药卫生—卫生事业管理]