就医重心下沉:理论、模式与路径

The Change in the Focus of Medical Services into Grass Roots:Theory Models and Paths

就医重心下沉是新医改的目标,但亟需系统,剖析。本文首先从理论上阐释了患者自由就医状态下可能的就诊路径以及要实现就医重心下沉的关键环节;其次从首诊和转诊两个维度,将国际现有典型就医重心下沉模式归纳提炼为四大类,并对各个模式的内涵进行路径选择;最后,对我国当前实践探索模式及其面临的主要问题,比如社区卫生服务机构的技术水平和与医院的收费差距等进行了简要分析,进而提出了"首先确定适合的目标模式,然后制定合适的步骤并渐进推进"的深化改革取向。

Starting with demonstrating theoretically the critical processes of the change in the focus of medical services into grass roots,this paper classifies the international mode]of the change in the focus of medical services into grass roots into four categories from the two dimensions of the first diagnosis and transfer treatment and analyzes their respective characteristics.At the same time,it also puts forward the theoretical paths and its corresponding options based on China＇s health care practice.In the end,it analyses the effects and problems of the pilot models and draws a brief conclusion.