我国开展“以人为本的一体化卫生服务”模式的挑战及对策  

Challenges and countermeasures of people-centred integrated care model in China

作　　者：张永光[1,2] 傅薇 王晓锋 张艳梅[2,4] ZHANG Yong-guang FU Wei WANG Xiao-feng ZHANG Yan-mei(Soft Science of Health Department,Yunnan Institute of Health Information,Kunming Yunnan 650010,China School of Public Health,Kunming Medical University,Kunming Yunnan 650500,China Financial Department,The Talent Exchange and Service Center of Yunnan Provincial Health Department,Kunming Yunnan 650200,China Supporting Deparment,Fuwai Cardiovascular Hospital of Yunnan Province,Kunming Yunnan 650031,China)

机构地区：[1]云南省医学信息研究所<卫生软科学>编辑部,云南昆明650010 [2]昆明医科大学公共卫生学院,云南昆明650500 [3]云南省卫生厅人才交流服务中心财务科,云南昆明650200 [4]云南省阜外心血管病医院运营保障部,云南昆明650031

出　　处：《中国卫生资源》2017年第6期525-530,共6页Chinese Health Resources

摘　　要：提出"以人为本的一体化卫生服务"(PCIC)模式是我国卫生服务体系改革的必然方向,并厘清了PCIC与我国倡导的分级诊疗的异同。认为推行PCIC能缓解我国现阶段卫生服务体系存在的"重治疗、轻预防""重服务、轻健康""看病难、看病贵"问题。基于国内部分实践案例,分析了我国推行PCIC在守门人制度、双向转诊、跨学科团队、基层医护人员收入、防治结合、价格杠杆、医联体、卫生信息化等方面存在的困难和挑战。根据国内外实践案例,提出了医院的全面纵向整合、各类服务的全面横向整合、建立统一的临床路径及行之有效的双向转诊制度、推行基层首诊制、组建行之有效的跨学科团队、借助电子健康系统等六个方面的对策建议。This article pointed out that the “people-centred and integrated health care”（PCIC） model was the inevitable direction of health care system reform in China,and clarified the similarities and differences between PCIC and hierarchical medical services. The implementation of PCIC could alleviate the problems of health care system reform at the present stage in China,such as “paying more attention to medical treatment than prevention”,“concerning more about medical service than health”,and “unreachable and expensive getting medical services”. The article analyzed the difficulties and challenges of the implementation of PCIC in China based on several domestic practices,including gatekeeper system,two-way referral,interdisciplinary team,the income of primary health care workers,prevention and treatment integration,price leverage,medical alliance,and health care informatization. Then it put forward countermeasures and suggestions for six aspects as followsthe overall vertical integration of hospitals,the overall horizontal integration of various services,establishing an unified clinical pathway and effective dual referral system,carrying out first diagnosis made by primary medical institutions,and building up an interdisciplinary team utilizing health system.

关 键 词：卫生服务体系 整合型 分级诊疗 医改 

分 类 号：R19-0[医药卫生—卫生事业管理]