国家卫生与健康管理大数据平台在医药卫生体制改革中的作用  

Function of the national big data platform for medical and healthcare management in medical and healthcare system reform

作　　者：李迎新[1] 黄河[1] Li Yingxin;Huang He(Institute of Biomedical Engineering, Chinese Academy of Medical Sciences ＆ Peking Union Medical College, Tianjin 300192, China)

机构地区：[1]中国医学科学院北京协和医学院生物医学工程研究所,天津300192

出　　处：《国际生物医学工程杂志》2018年第1期1-10,共10页International Journal of Biomedical Engineering

摘　　要：医药卫生体制改革是我国医药卫生事业发展的必然过程，主要内容是建立科学合理的分级诊疗制度、建立科学有效的现代医院管理制度、建立高效运行的全民医疗保障制度、建立规范有序的药品与医疗器械供应保障制度和建立严格规范的综合监管制度。国家卫生与健康管理大数据平台能在我国医改中发挥重要作用，可有效提高疾病治疗效果、改善预后、降低疾病发病率和死亡率，提高全民健康水平；可对医保基金进行风险防控，有效降低基金运行风险；可提高医疗卫生服务效率，更合理地利用医疗服务资源，降低医疗费用；可将居民与家庭医生、各级医院联系起来，并通过电子化签约、在线预约、远程医疗、双向转诊、健康实时监测等手段完善医联体制度，助力分级诊疗；有助于建立源头可溯、全程可控、风险可防、责任可究、绩效可评、公众可查的医药、医械流通体系；可有效提升我国医疗体系质量评价和监管水平。对我国医改中存在的问题进行了介绍，对国家卫生与健康管理大数据平台与医改的关系及对医改的意义进行了分析。The reform of medical and healthcare system is the inevitable process for the medical and healthcare developing in China.The main contents of the reform include establishing a scientific and reasonable system of medical treatment and classification,a scientific and effective modern hospital management system,a universal medical insurance system with efficient operation,a standardized and orderly drugs and medical equipment supply,and a strict and standardized comprehensive supervision system.The national big data platform for medical and healthcare management can play an important role in the reform of medical and healthcare system in China.First,it can help to improve the treatment effect of the disease,improve the prognosis,reduce the morbidity and mortality rate,and improve the health level.Second,it can effectively control the risk of medical insurance funds,and reduce the fund operational risk.Third,it can improve the efficiency of healthcare services and medical service resource utilization,so as to reduce medical costs.Fourth,it can help to build the link between residents and family doctors and hospitals,and to promote the medical consortium and hierarchical medical system through electronic signatures,online booking,telemedicine,real-time health monitoring,and two-way referral.Fifth,it can help to establish a medicine and medical equipment circulation system with the characteristics of source-traceable,full controllable,risk-preventable,responsibility-assessable,performance-assessable,and open-and-transparent.Finally,it can effectively improve the quality evaluation and regulatory level of the medical system in China.The existing problems in medical reform in China were introduced,and the relationship and the significance of the national big data platform for medical and healthcare management to medical and healthcare system reform were analyzed.

关 键 词：健康医疗大数据 医药卫生体制改革 分级诊疗 医疗保险监督 医疗机构评价 医药医械监管 

分 类 号：R197.1[医药卫生—卫生事业管理]