广西临桂医共体建设中资源-医疗-医保系统协同发展研究——基于复合系统协同度模型  

Researches on the Synergistic Development of Resource-Healthcare-Medicare System of Lingui County Medical Alliance in Guangxi Based on the Synergy Model of Composite System

作　　者：李继宏 劳颖谦 谢福生 唐宇婷 杨兆城 郭振友 刘梦青 Li Jihong(Guilin Medical University,Guilin,P.R.China)

机构地区：[1]桂林医学院人文与管理学院,广西桂林541199 [2]广西临桂区医共体理事会.桂林医学院第二附属医院 [3]桂林医学院财务处

出　　处：《中国卫生事业管理》2024年第6期641-644,共4页Chinese Health Service Management

基　　金：国家自然科学基金项目“基于整合IMB模型的广西农村老年人艾滋病高危行为与干预研究”(72064011);广西桂林市科技计划项目“基于县域一体化视角的紧密型医共体运行管理模式构建研究——以桂林市为例”(2021022786);广西八桂学者“社会医学与卫生事业管理”岗位基金资助。

摘　　要：目的:测量广西临桂医共体的资源-医疗-医保系统协同发展水平,研究其建设实效与改革经验,为经济欠发达地区医共体建设提供参考。方法:收集该医共体2018年~2022年“紧密型县域医共体绩效监测系统”部分填报数据,采用CRITIC赋权法和复合系统协同度模型,测量医疗资源配置、医疗服务提供与医保基金使用子系统有序度和医共体复合系统协同度。结果:医疗服务提供子系统有序度从2018年0.12027增长到2022年0.27731,医疗资源配置和医保基金使用子系统有序度均呈现改革前(2020年)下降改革后上升趋势,2022年医疗资源配置子系统有序度最低(0.18245),医疗服务提供子系统有序度最高(0.27731),2018年~2022年医共体复合系统协同度呈现从无序(协同度<0)向有序(0<协同度<0.3)发展趋势。结论:县域内医疗资源利用率、医疗服务能力和医保基金使用效能均呈现不同程度提升,但医共体整体发展水平仍处于低度协同阶段,需加强医共体运行制度执行合力与协同效应提升子系统间协同发展水平,促进医共体可持续发展。Objective To measure the synergistic development degree of resource-healthcare-medicare system of Lingui County Medical Alliance in Guangxi,study its construction effectiveness and reform experience,and provide reference for construction of county medical alliance in economically underdeveloped areas.Methods Data of"Performance Monitoring System of Compact County Medical Community"from 2018 to 2022 were collected.The order degree of subsystem,such as medical resource allocation,medical service provision and medicare utilization,and the synergy degree of composite system were measured by CRITIC method and Synergy Model of Composite System.Results The order degree of medical service provision subsystem has increased from 0.12027 in 2018 to 0.27731 in 2022.Medical resource allocation and medicare utilization subsystem showed a decreasing trend before 2020 and an increasing trend after 2020.Medical resource subsystem was the lowest(0.18245)and medical service provision subsystem was the highest(0.27731)in 2022.The synergy degree showed a trend from disorder to order from 2018 to 2022.Conclusion Utilization rate of medical resources,medical service capacity,and efficiency of medical insurance funds utilization within the county have all shown various degrees of improvement.However,the development level of medical community is still in a low stage of synergy.It is necessary to enhance joint execution and collaborative effect of operation system to improve the collaborative development among different subsystems and promote the sustainable development of county medical alliance.

关 键 词：紧密型县域医共体 复合系统协同度模型 医疗资源配置 医疗服务能力 制度协同 

分 类 号：R197.3[医药卫生—卫生事业管理]