分级诊疗背景下医院托管效果评价特殊性思考与启示  

Reflections on the special evaluation of hospital custody under the background of hierarchical diagnosis and treatment

作　　者：蔡进 CAI Jin(The 1 st People’s Hospital of Guangzhou,Guangzhou 510000,China)

机构地区：[1]广州市第一人民医院,广东广州510000

出　　处：《现代医院》2020年第4期480-483,共4页Modern Hospitals

基　　金：广东省部产学研结合项目(2013B090600139);广东省卫生经济学会2018年科研项目立项重点课题(2018-WJZD-07)。

摘　　要：近年来,推动分级诊疗作为当前医改中最重要的环节,落实效果并不理想。大医院托管小医院、三甲医院托管县医院、基层医院等托管行为是促进优质医疗资源下沉、推动分级诊疗的重要手段之一。托管行为频发,但其效果如何并无太多考核。没有全面的考核,便很难有及时合理的改进。医院托管是特殊的医院经营行为,不同于普通医院的经营,因而对于医院托管行为的考核与托管医院效果的评价,也有其特殊性。本文在国内外文献的基础上,结合实际,尝试总结出医院托管效果评价的七点特殊性:医改目的性、契约性、可持续性、冲突性、公益性、经济性和政府性。可为医院如何完善托管行为以及后续医院托管效果评价体系的构建提供思路与参考。In recent years,the promotion of hierarchical diagnosis and treatment has been the most important part of the current medical reform,and the implementation effect is not satisfactory. Small hospitals in the custody of larger hospitals,and county-level and basic-level ones in tertiary hospitals are one of the important means to promote the sinking of high-quality medical resources and promote hierarchical diagnosis and treatment. Custody behavior is frequent,but how effective it is has not been evaluated. Without a comprehensive assessment,it is difficult to make timely and reasonable improvements. Hospital custody is a special hospital operation behavior,which is different from the operation of ordinary hospitals. Therefore,the evaluation of hospital custody behavior and the evaluation of the effect of custody hospitals are also unique. Based on domestic and foreign literature,this article attempts to summarize the seven particular features of the evaluation of hospital custody effects: the purpose of medical reform,contractuality,sustainability,conflict,public welfare,economics,and government. It can provide ideas and references for how to improve the hospital’s custody behavior and the establishment of a follow-up hospital custody effect evaluation system.

关 键 词：分级诊疗 托管 效果评价 特殊性 

分 类 号：R197[医药卫生—卫生事业管理]