紧密型县域医共体慢性病医防协同工作的系统动力学分析——以福建尤溪为例  

A system dynamics analysis of collaborative work on chronic disease control and prevention in compact medical community:A case study of Youxi County,Fujian Province

作　　者：吾麦尔艾力·阿力木 吴雨荷 王淑荟 邓嘉慧 卢若艳[1] WUMAIERAILI Alimu;WU Yuhe;Wang Shuhui;DENG Jiahui;LU Ruoyan(School of Public Health,Fujian Medical University,Fuzhou,Fujian 350108,China)

机构地区：[1]福建医科大学公共卫生学院/卫生管理学院,福建福州350108

出　　处：《中国农村卫生事业管理》2023年第6期397-401,共5页Chinese Rural Health Service Administration

基　　金：福建省社会科学基金项目(FJ2022B075)。

摘　　要：目的 了解紧密型县域医共体慢性病医防协同工作开展的动力机制。方法 运用系统动力学方法,确定核心变量,从慢性病一体化管理、疾控入驻县总医院、医保支付方式、绩效考核4个纬度进行动力机制分析。结果 尤溪县的慢性病一体化的管理模式形成正向的激励循环机制,促进医务人员的积极行为;疾控参与紧密型县域医共体的医防协同工作实现慢性病防治专业化与协同发展;薪酬制度改革推动绩效管理,提高医保经费使用效率,进而增加医务人员收入,医务人员投入到慢性病医防协同工作的主动意愿增强。结论 尤溪县医防协同政策形成了正向的激励循环机制,建议进一步健全以长期效益为导向的考核指标和激励制度,加强人才队伍建设,增强政策协同效应。Objective To explore the dynamic mechanism of the collaborative work of chronic disease preven-tion and treatment in the compact county-level medical community.Methods The system dynamics method was used to determine the core variables,and the dynamic mechanism was analyzed from four dimensions:the integrat-ed management of chronic diseases,representative of center for disease control settled into the county general hos-pital,the payment method of medical insurance,and the performance appraisal.Results The integrated manage-ment model of chronic diseases in Youxi County formed a positive incentive cycle mechanism to promote the posi-tive behavior of medical staff.Representatives of center for disease control participated in the compact county-level medical community's medical and preventive collaborative work to achieve the specialized and coordinated develop-ment of chronic disease prevention and treatment.Salary system reform promotes performance management and im-proves the efficienc of medical insurance funds,and then raised the income of medical personnel so that the medi-cal personnel took initiative to be engaged in the collaborative work of chronic disease control and prevention.Conclusions Youxi County's prevention-treatment coordination policy has formed a positive incentive cycle mechanism.It is recommended to further improve the long-term benefit-oriented assessment indicators and incentive system,strengthen the development of talent teams,and enhance policy synergy.

关 键 词：医防协同 系统动力学 紧密型县域医共体 慢性病 薪酬制度改革 医保支付方式改革 

分 类 号：R197[医药卫生—卫生事业管理]