pp2-1-何国平-中英对照-中澳老年痴呆社区护理现状与展望 .pptVIP

社区护理实践发展关键问题 1.落实“双向转诊”制度 首先要解决好四大瓶颈问题： 瓶颈一，社保规定成拦路虎，因社保的区域性非常强，转诊住院报销受影响； 瓶颈二，患者就医观念存在误区，对社区医护人员不信任，担心影响治疗效果； 瓶颈三，化验检查结果难互认，重复检查，多花钱，伤身体； 瓶颈四，就医逐利，医院、社区各有说法 28 1.Carry Out Mutual Referral System First must be solved four bottleneck problems： Bottleneck one，The provisions of social insurance get in the way，Because of regional characteristic of social insurance is very distinct, hospital transfer reimburses is affected; Bottleneck two，The patients idea about see a doctor is wrong, distrust the community medical personnel, worry about influence treatment result； Bottleneck three，Check-up result is difficult to recognize mutually, repetitive inspection lead to spend more and is harm to body; Bottleneck four，Providing health care service or making profit, the hospital and community has different perspectives. The key questions of community nursing practice development 28 2.改革社区卫生服务收支制度 建立新的社区卫生服务运行模式，实行“收支两条线管理” 明确了社区卫生服务机构是政府主办的公益性事业单位 探索新的考核分配机制 ：按岗定酬、按任务定酬、按居民满意度定酬、按解约医疗费用定酬等 29 2. Innovate income and expense system of community health service Establish new community health service movement pattern, implement the separating management system of the revenue and expenditure Definite community health service organization is the public welfare institution which the government sponsors. Explore new check assignment mechanism: Decide reward according to the type of work, decide reward according to task,decide reward according to inhabitant degree of satisfaction,according to terminate an agreement of the medical expense to decide the reward and so on 29 3.强化政府管理 （1）必须明确政府有义务和责任保证每个公民的社会权利和健康权利 （2）政府在医疗卫生领域应以公益性为目标，使人们都能相对平等地享受健康保健的权利。 （3）政府要建立建全适应社区卫生改革与发展需要的卫生标准管理体制，将社区卫生标准纳入法制化、规范化的管理轨道，提高参与国家卫生标准工作的能力。 30 3.Intensify the management of the government （1）Must be clear about government have the duty and the　 responsibility to guarantee each citizens social right and health right. （2）Government should take the publ