美国卫生体系整合模式探索及其对我国的启示  

Analysis of the integrated healthcare model of the US health system and its enlightenment to China

作　　者：柏杨 祝贺 马晓晨 何平 袁蓓蓓 孟庆跃 徐进 BAI Yang;ZHU He;MA Xiao-chen;HE Ping;YUAN Bei-bei;MENG Qing-yue;XU Jin(China Center for Health Development Studies,Peking University,Beijing 100191,China)

机构地区：[1]北京大学中国卫生发展研究中心,北京100191

出　　处：《中国卫生政策研究》2020年第2期46-52,共7页Chinese Journal of Health Policy

基　　金：国家卫生健康委员会体改司“以人为本整合型医疗卫生服务体系框架研究”;北京大学优博培育计划(BMU2017YB006)。

摘　　要：我国正在大力探索建设优质高效的以人为本的整合型医疗卫生服务体系。面对卫生体系严重的碎片化问题,美国近年来在卫生服务的整合方面做了不少尝试。其中,在建设责任型保健组织(Accountable Care Organization, ACO)和以患者为中心的医疗之家(Patient-Centered Medical Home, PCMH)方面取得了一些有益的经验。本文在文献综述基础上探讨了这两类实践的主要做法、成果、问题,及其对我国支付方式改革、医疗卫生机构整合、基层医疗卫生服务团队建设、卫生信息体系整合及如何因地制宜推进整合改革的相关启示。China is actively exploring the construction of a high-quality and efficient People-Centered Integrated Healthcare system.The US America has made great efforts in the integration of healthcare services,purposed to address the problem of healthcare system fragmentation.Thereinafter,several organizational experiences have been gained from the establishment of the Accountable Care Organization(ACO)and Patient-Centered Medical Home(PCMH).Based on the review of existing researches,this study discussed the practice and achievements of ACOs and PCMHs,and obstacles that hamper the full play of these policies.Potential implications were also drawn from these healthcare development policies,and are suggested to China s reform in the payment modes,the integration of medical institutions,the construction of primary healthcare teams,the health information system integration,and in the promotion of the system integration in accordance with local conditions;which should acutely revolutionize China s healthcare system with fully integrated practices conducive to a new top level model of healthcare system.

关 键 词：整合型卫生服务 责任型保健组织 以患者为中心 医疗之家 支付方式 

分 类 号：R197[医药卫生—卫生事业管理]