天津市整合型服务体系的构建、成效及问题分析  

Analysis on the construction,efficiency and problem of integrated service system in Tianjin

作　　者：王书平 曾宇琦 潘斐斐 孙雯[5] 闫丽娜 窦双祥 WANG Shu-ping;ZENG Yu-qi;PAN Fei-Fei;SUN Wen;YAN Li-na;DOU Shuang-xiang(Health Development Research Center of National Health commission,Beijing 100191,China;China Health Economics Association,Beijing 100191,China;Xi an Jiaotong University,Xi an 710049,China;Guanxin Software Co.,Ltd.Beijing 100191,China;The Affiliated Tumor Hospital of Guangxi Medical University,Nanning Guangxi 530021,China;Tianjin Community Association,Tianjin 300052,China)

机构地区：[1]国家卫生健康委卫生发展研究中心,北京100191 [2]中国卫生经济学会,北京100011 [3]西安交通大学,陕西西安710049 [4]冠新软件股份有限公司,北京100191 [5]广西医科大学附属肿瘤医院,广西南宁530021 [6]天津市社区协会,天津300052

出　　处：《卫生软科学》2022年第11期5-9,共5页Soft Science of Health

基　　金：中国与世界卫生组织2020-2021双年度合作项目-中国优质高效医疗卫生服务体系构建(GJ2-2021-WHOPO-E1)。

摘　　要：通过访谈调研,总结天津市实施镇村一体化机制、构建区级牵头医院与基层医疗机构紧密型医共体开展基层数字健共体,打造云管理、云服务、云药房和云检验平台的经验。通过构建整合型服务体系,牵头医院出院患者三四级手术占比由2018年的31.49%增加至2020年的33.44%,县域内基层机构门急诊人次数占比由2018年的50.2%上升至2020年57.4%。在医共体内统一药品目录,确保基层单位配备常用慢性病药品45个品种、196个品规。门诊收费中药占比快速上升,由2018年的76.6%增加至2020年的85.7%。天津市在构建整合型服务体系的实践中成效明显,但在紧密型医共体的组织框架和运行机制、牵头医院医防融合、城市城区紧密型医共体专科特色和数字健共体嵌入式发展运行机制等方面还需要进一步明确和加强。Through interviews and surveys, this paper summarizes the experience of implementing the integration mechanism of towns and villages in Tianjin, building close-type medical alliance between district-level leading hospital and primary medical institutions to carry out grassroots digital health community, and building cloud management, cloud service, cloud pharmacy and cloud inspection platform. Through the construction of integrated service system, the proportion of discharged patients from the leading hospital for third-and fourth-level surgeries increased from 31.49% in 2018 to 33.44% in 2020. The proportion of outpatient visits in grass-roots institutions in the county increased from 50.2% in 2018 to 57.4% in 2020. A unified drug catalog within the medical alliance ensures that grassroots units are equipped with 45 varieties of commonly used chronic disease drugs and 196 product specifications. The proportion of traditional Chinese medicine in outpatient fees showed a rapid rise, which increased from 76.6% in 2018 to 85.7% in 2020. It has achieved remarkable results in the construction of integrated service system in Tianjin. However, the organizational framework and operation mechanism of close-type medical alliance, the integration of medical prevention and treatment of leading hospitals, the specialty characteristic of close-type medical alliance in urban areas and the operation mechanism of embedded development of digital health community need to be further clarified and strengthened.

关 键 词：紧密型医共体 数字健共体 构建 整合型服务 

分 类 号：R197[医药卫生—卫生事业管理]