紧密型县域医共体政策梳理及改革发展建议  

Policy review and suggestions on reform and development of compact county medical communities

作　　者：朱欢欢 马建根 柳丽佳 宋晓青 魏晋才 ZHU Huanhuan;MA Jiangen;LIU Lijia;SONG Xiaoqing;WEI Jincai(School of Innovation and Entrepreneurship Education,Wenzhou Medical University,Wenzhou,Zhejiang 325000,China;Huzhou Municipal Health Commission,Huzhou,Zhejiang 313000,China;School of Public Health and Management,Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州医科大学创新创业教育学院,浙江温州325000 [2]湖州市卫生健康委员会,浙江湖州313000 [3]温州医科大学公共卫生与管理学院,浙江温州325000

出　　处：《中国农村卫生事业管理》2023年第2期112-118,共7页Chinese Rural Health Service Administration

基　　金：浙江省卫生健康委员会重点课题(SKHX2022);浙江省康恩贝医院管理软科学研究项目立项课题(2021ZHA-KEB104)。

摘　　要：县域医共体建设发展至今,其运行框架已基本成熟,但是一些痼疾一时还难以被解决。文章回顾我国县域医疗卫生服务体系改革历程,梳理紧密型县域医共体政策架构和改革试点的进展,对现阶段紧密型县域医共体建设过程中仍面临的主要障碍和重点任务进行分析,发现在现代医院管理制度纵深推进存在障碍,医疗卫生服务连续性、创新性有待加强,深化支付方式改革,提高绩效管理水平仍是重点工作,提升县域医疗提供能力,优化总体服务水平是总体工作目标。文章通过借鉴德清县武康健康保健集团紧密型县域医共体建设取得的成效及示范经验,得出需要加快现代医院管理制度和紧密型县域医共体建设协同推进;需要数字赋能医防融合,提升医疗卫生服务供给创新性;需要深化支付方式改革,提高绩效管理水平;需要加强全科医生人才培养和重点学科建设,提升县域医疗总体服务能力的建议,以期为进一步完善医共体政策架构和推进医共体建设实践提供决策参考。Up to now, the operating framework of county medical communities has been basically mature. However, some problems are still difficult to solve. This article reviewed the reform of county health service system in China, clarified the policy framework of compact county medical communities and the progress in the pilot reform, analyzed the major obstacles and key tasks, and found that there were obstacles in the in-depth promotion of modern hospital management system, health service continuity and innovation needed to be strengthened, deepening the reform of payment mode and improving the performance management were still the key tasks, and improving the capacity of county medical services and optimizing the overall service level were the overall work goals. By referring to the achievements and demonstration experience of the construction of the compact county medical community of Deqing County Wukang Health Care Group, it is concluded that the modern hospital management system and the construction of the compact county medical community need to be accelerated. It is necessary to enhance the innovation of medical and health service supply by enabling the integration of medical careand prevention with digital data, to deepen the reform of payment mode and improve the level of performance management, to strengthen the training of general practitioners and the development of key disciplines, and to improve the overall service capacity of county medical services, so as to provide decision-making reference for further improving the policy framework and promoting the construction practiceof medical communities.

关 键 词：县域医共体 政策 改革 医疗健康服务集成 现代医院管理制度 医防融合 

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]