双向转诊机制的实现

How to Develop a Dual Referral System in Health Care

双向转诊是社区卫生服务的一个重要服务环节。中国目前采取的各种双向转诊措施效果甚微,究其根由,是系统大环境问题,尤其是市场竞争对合作造成的障碍。因此,政府必须从宏观层面上采取多种手段,如以初级保健为核心的社会医疗保险、人力资源统筹规划、卫生机构功能分工、经济激励机制、准入与评审、信息系统建设等,有意识地调控市场,创造有利于实现双向转诊的系统环境。本文深入分析了澳大利亚在上述领域的做法,对中国可能有一定的借鉴价值。

Dual referral is one of the integrated components in community health service. The current Chinese system has not worked well due largely to the system barriers; in particular, the disincentives for collaborations resulted from the intense competition among service providers. The government has to adopt macro - level regulatory strategies, such as a primary care led medical insurance scheme, human resources planning, complementary institutional functions, financial incentives, entry control and accreditation, and information infrastructures, in order to build and facilitate a better system environment for effective dual referral. This article analyzed the Australian experiences, which might have implications to the Chinese reform.