区域医疗联合体发展过程中困难分析.docVIP

区域医疗联合体发展过程中困难分析 　　【摘要】 国际经验表明，发展医疗联合体，合理整合医疗资源，充分发挥社区卫生服务机构和全科医师的“健康守门人”作用，对于改变基层医疗资源利用严重不足、大医院人满为患的倒金字塔结构有很大作用。医疗联合体在一定行政区域范围内通过医疗机构分级管理、整合内部医疗资源、利用区域优质医疗资源为广大人民群众服务，但在实施过程存在很多壁垒及困难。文章通过分析相关因素，探讨解决问题的办法， 如政府主导、全科医师的培养、社区首诊和双向转诊制度的完善、信息系统的建设及医保支付制度的完善等，对我国医疗联合体的建设与发展提出相应的建议。 　　【关键词】 医疗联合体； 发展过程； 困难分析 　　【Abstract】 International experience has showed that the medical association was a good development mode to integrate the medical resources， guarantee the community hospital and general practitioner to act as health gatekeeper，change the serious shortage of medical resources in the basic institutions， and release the burden of patients for large hospital.Medical Association in certain administrative areas by classification of medical organization management， the integration of internal resources， the medical service for the masses and utilization of high quality medical resources in the area， but there are many barriers and difficulties in the implementation process. Through the analysis of relevant factors， to explore the way to solve the problem， such as the construction and the medical insurance payment system of government leading； the GPs’ training； make the visit of the doctor start from the practitioner community， and perfect two -way referral system， information system construction and the construction of payment system of medical insurance，the corresponding suggestion were put forward on the construction and development of Chinese Medical Association. 　　【Key words】 Medical association； Development process； Difficult analysis 　　First-author’s address：Shinan District Community Health Service Management Center of Qingdao City， Qingdao 266071，China 　　doi：10.3969/j.issn.1674-4985.2015.09.037 　　医疗联合体，即由一所三级医院联合一定区域范围内的二级医院和社区卫生机构组成“联合体”，医联体内各合作单位双向转诊；居民则选择就近医疗联合体签约就医，在社区首诊，逐级转诊。 　　建立医联体的目的是要改变三级医院人满为患、患者就医艰难且部分高端医疗资源浪费，而基层社区医疗机构却“门可罗雀”的倒金字塔状况；推行医联体后，通过医保报销政策引导患者分层次就医，大部分轻症、常见病及稳定期慢性病患者选择到一、二级医疗机构就诊，而三级医院将精力重点放在疑难重症患者和专科诊疗上，医疗资源得以缓解并有时间和空间开展科研创新，形成正金字塔式的就医格