深圳市基层医疗卫生机构医防融合服务提供面临的困境与发展策略  

Dilemma and Development Strategy of the Provision of Medical Care and Prevention Integration Services in Grassroots Medical Institutions in Shenzhen

作　　者：刘兰芳 姚岚[1] 邱增辉 彭瑾 陈瑶 LIU Lanfang(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,430030,China)

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030 [2]深圳市卫生健康发展研究和数据管理中心,广东深圳518000

出　　处：《医学与社会》2024年第12期18-25,共8页Medicine and Society

基　　金：国家自然科学基金资助项目,编号为72074090。

摘　　要：目的:以全科医学服务为切入点,探析深圳市基层医疗卫生机构医防融合服务提供过程中面临的现实困境,围绕组织架构、服务模式等提出基层医防融合高质量发展的相关建议。方法:通过对5名基层医疗卫生机构管理人员、10名基层全科医生开展半结构化深度访谈,选择主题分析法对访谈资料进行分析,探讨深圳市基层医防融合推进过程中面临的现实问题。结果:31项一级描述性主题编码共涉及281个参考点,对10项二级分析性主题归纳总结,深圳市基层医疗卫生机构医防融合服务提供困境最终共形成4项三级概括性主题,即人力资源配置结构有待优化、团队协作效能尚未充分发挥、激励机制仍需健全、数字信息技术赋能有待加强。结论:深圳市医疗与预防融合发展格局已基本建成,但基层医疗机构内部医防融合服务提供过程中面临效率有待提高、服务质量有待提升等问题。需进一步发挥全科与专科协同作用、打破人力资源配置局限、优化激励机制导向、探索基层医防智能融合策略,为基层医疗卫生机构医防融合服务高质量发展提供良好环境,以实现全生命周期健康管理目标。Objective:Taking general medicine services as the starting point,this paper analyzed the practical difficulties in the process of providing medical care and prevention integration services in grassroots medical and health institutions in Shenzhen,and put forward relevant suggestions for the high-quality development of grassroots medical care and prevention integration around the organizational structure and service model.Methods:Semi-structured in-depth interviews were conducted with 5 managers of grassroots health care institutions and 10 grassroots general practitioners,and the interview data were analyzed by thematic analysis to discuss the practical problems faced in the process of promoting the integration of grassroots medical care and prevention in Shenzhen.Results:With a total of 281 reference points involved in 31 first-level descriptive topic coding,and 10 second-level analytical themes summarized,the dilemma of medical care and prevention integration service provision in grassroots medical institutions in Shenzhen was finally formed:the human resource allocation structure needed to be optimized,the teamwork efficiency had not been fully utilized,the incentive mechanism still needed to be improved,and the empowerment of digital information technology needed to be strengthened.Conclusion:The integrated development pattern of medical care and prevention in Shenzhen has been basically completed,but the problems of efficiency and service quality of medical care and prevention integration services in grassroots medical institutions are faced in the process of providing internal medical care and prevention services.It is necessary to further give full play to the synergy between general practice and specialty,break the limitations of human resource allocation,optimize the orientation of incentive mechanism,and explore the strategy of intelligent integration of grassroots medical care and prevention services,so as to provide a good environment for the high-quality development of medical care and prevention int

关 键 词：医防融合 服务 基层医疗卫生机构 深圳 

分 类 号：R-05[医药卫生] R197.6