我国实现分级有序医疗的障碍及对策

Obstacles and strategies on bottom-up cascading healthcare practice in China

本文简要概述了当前就医行为错位、混乱和无序的现象,说明存在卫生资源匮乏与相对富余的结构性矛盾,从政策制定与实施过程中的问题以及制度本身所固有的缺陷、市场发育和健康社会文化等方面初步分析了上述现象产生的原因,提出了理顺医疗服务价格机制、建立与恢复转诊制度、增强公众对基层医疗卫生服务的信心以及通过健康教育推动健康社会文化建设等方面的政策建议,以实现分级有序医疗,改善资源利用效率,确保我国医改预期目标的实现。

In this paper, we describe mismatch, chaos, and disorder behavior during healthcare seeking. Such structural imbalances, scarcity and surplus make healthcare services less efficient. We give reasons for such phenomena in terms of long-term effects of health resource allocation policy-making and implementation, inherent de- fects within heahhcare insurance, incomplete market development, and cultural issues. We then propose four policy strategies, including rational price mechanism, strict referral healthcare system, confidence in basic heahhcare facili- ties, and proper heahhcare cultures. These will restore orderly healthcare behavior and help realize expectations for the current heahhcare reform in China.