德清县域医共体改革:问题与对策  

Reform of the county-based healthcare communities in Deqing County: Problems and countermeasures

作　　者：沈信姿 董建新 吴素雄[1] SHEN Xinzi;DONG Jianxin;WU Suxiong(School of Public Health and Management,Wenzhou Medical University,Wenzhou,Zhejiang 325000,China;School of Medicine,Huzhou University,Huzhou,Zheijing 313000,China)

机构地区：[1]温州医科大学公共卫生与管理学院,浙江温州325000 [2]湖州师范学院医学院,浙江温州313000

出　　处：《中国农村卫生事业管理》2022年第1期46-51,共6页Chinese Rural Health Service Administration

基　　金：国家社会科学基金项目(20BZZ045);湖州师范学院人文社科专项项目(2021XJWK02)。

摘　　要：德清县域医共体改革缘起于周边城市大医院的虹吸作用所导致的医保基金外流以及自身医疗服务传递体系的碎片化。基于浙江省县域医共体首批试点县的经验以及县域较强的综合实力,德清县有实力和基础对县域医共体进行改革。德清县从组织架构、体制机制、保障体系和服务模式四个维度进行改革,在改革进程中出现了行政干预过强、医疗市场单一、多重法人并存以及三医联而不动等问题,这需要通过探索建立协同式的法人治理结构、促进医疗市场良性竞争以及推动三医联动与三医平衡来协同解决。The reform of the county-basedhealthcare communities in Deqing County originated from the outflow of medical insurance funds caused by the siphon effect of general hospitals in surrounding cities and the fragmentation of its own medical service transmission system.Based on the experience of the first batch of pilot county-based healthcare communities in Zhejiang Province and strong comprehensive strength, Deqing County has the strength and foundation to carry out reform of county-basedhealthcare community. The reform is taken from four dimensions of organizational structure, system and mechanism, guarantee system and service mode. During the process of reform, there are problems such as too much administrative intervention, a single medical market, coexistence of multiple juridical persons and inefficiency of the tripartite system reform. Thus, it is necessary to carry out the exploration in the establishment of a coordinated corporate governance, promotion of healthy competition in the medical market and promotion of the tripartite system reform and balance among the medical treatment, medicine and medical insurance.

关 键 词：医共体 三医联动 市场竞争 

分 类 号：R19[医药卫生—卫生事业管理] R197.3[医药卫生—公共卫生与预防医学]