试述分级诊疗模式及实施对策  

Discussion on the Model of Graded Diagnosis and Treatment and the Countermeasures

作　　者：张爽 何克春[2] 袁红梅[3] 杨燕[3] ZHANG Shuang;HE Kechun;YUAN Hongmei;YANG Yan

机构地区：[1]湖北省直公立医院管理中心,湖北武汉440000 [2]三峡大学人民医院三峡大学卫生经济研究所,湖北宜昌443000 [3]宜昌市第一人民医院,湖北宜昌443000

出　　处：《现代医院》2018年第4期471-474,共4页Modern Hospitals

基　　金：湖北省卫生计生委指定性项目(WJ2017D0011);湖北省教育厅人文社科重点课题(17D022)

摘　　要：目的我国医疗体系存在着卫生资源配置不平衡和患者"择优不择廉"的就医心理,导致优质的医疗资源和患者过度的集中于大医院,而基层医疗机构却由于硬件条件和技术力量的不足,生存发展出现了非良性的循环。笔者结合医疗服务现状,探讨我国分级诊疗服务的健康发展策略。方法主要运用比率法和描述性统计方法。结果分级诊疗实施不顺畅的原因主要是因为患者首诊选择基层医疗机构意愿不高,上下联动机制尚未有效建立,经济杠杆导向作用不明显。结论加快基层卫生资源配置,提升卫生服务能力和水平是顺利推进分级诊疗的基础和根本保障。Objective there is an imbalance in the allocation of health resources and patients＂merit without merit＂medical psychology in the health care system of China,leading to high-quality medical resources and patients over the large concentration of hospitals,and primary health care institutions because of hardware conditions and technical strength,survival and development of a non-virtuous circle. Based on the current situation of medical services,this paper discusses the healthy development strategy of graded clinics in China. Methods Mainly use ratio method and descriptive statistical method. Results The reasons for the poor implementation of grading clinics are mainly due to the low willingness of patients to choose primary medical institutions in the first consultation,the establishment of an up-and-down linkage mechanism has not been established effectively,and the role of economic levers has not been obvious. Conclusion We should speed up the allocation of health care at the grassroots level,improve the ability and level of health services is to promote the gradual diagnosis and treatment of basic and fundamental protection.

关 键 词：分级诊疗 双向转诊 医疗服务体系 

分 类 号：R197[医药卫生—卫生事业管理]