县级医生服务分工与协作的PEST-SWOT分析  

PEST-SWOT Analysis of County-level Doctor Service Division and Cooperation

作　　者：谢乐威 张研[1,2] 韦倩晨 叶亦盛 刘彦辰 吴文琪 林琳 田盾 张亮 XlE Le-wei;ZHANG Yan;WEI Qian-chen

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030 [2]湖北省人文社科重点研究基地农村健康服务研究中心,湖北武汉430030

出　　处：《中国医院管理》2018年第8期26-29,共4页Chinese Hospital Management

基　　金：国家自然科学基金青年基金资助项目(71603088);中央高校基本科研业务费资助华中科技大学自主创新研究基金(2016AA021)

摘　　要：县级医生服务分工与协作是推进分级诊疗最重要的靶点之一,也是保障居民获得连续性医疗服务的关键作用点。建立县级医生服务分工与协作PEST-SWOT分析模型,分析得出县级医生服务分工协作面临政策、技术支持的机遇,但在经济、管理模式方面威胁众多。结合上述模型,分析甘肃、安徽、湖北三省助力县乡服务分工协作的医改政策,甘肃省政策符合WO争取型建议特征,但容易导致县级医生推诿高医疗费用病人;安徽省政策整体内容偏向ST抗争型建议,但无法消除县乡医生的利益竞争关系;湖北省医改模式符合SO开拓型建议,创新性明显。综合分析得出亟待利用政策技术机遇调整医院战略导向,改革医生绩效监督管理机制,完善分工保障机制。同时应激活基层医疗机构,提高县乡两级医生之间的信息通达度,管理规范医生行为解决诊疗固化问题。The division of labor and cooperation of county doctors is one of the most important targets for advance-ment of grading diagnosis and treatment, and it also plays a key role for ensuring patients to obtain continuous services. PEST-SWOT analysis model of county-level doctors＇ service division of labor and collaborative is established, and it is analyzed that county-level doctors＇ service division and cooperation face the opportunity of policy and technical sup-port, but there are many threats in economy and management model. Gansu Province＇s policies conform to the charac-teristics of the VVO proposal type, but it is easy for county doctors to push patients at high medical expenses. The over- all content of the Anhui Province＇ s policy is biased towards the ST anti-competitive proposal, but it cannot eliminate the competition between the doctors in the county and township areas. The medical reform model in Hubei Province is in line with the SO exploration proposal and has obvious innovation characteristic. The comprehensive analysis con-cludes that it is urgent to use policy and technical opportunities to adjust the hospital＇s strategic orientation, reform the doctor＇s performance supervision and management mechanism, and improve the division of labor protection mechanism. At the same time, primary medical institutions should be activated to increase the degree of information access between doctors at county and township levels, and to standardize the behavior of doctors to solve the prob-lem of diagnosis and treatment solidification.

关 键 词：分级诊疗 县级医生 医生行为 分工协作 PEST-SWOT模型 

分 类 号：R197.3[医药卫生—卫生事业管理]