上海市级医院急诊医疗服务现状与思考

Thoughts and status quo of emergency medical care in Shanghai municipal hospitals

通过文献评阅、问卷调查、关键知情人访谈和专题小组讨论等方式,调研上海市级医院急诊医疗服务现状,指出当前存在的突出问题是急诊入口无序和出口不畅,分析其原因包括社会因素、卫生服务体系不完善、物价及医保等政策的引导支持不足、急诊急救相关规范不完善或落实困难等。建议推动急救立法及贯彻落实,落实急诊医疗服务各相关方的权利及义务;加大宣传和信息公开,引导患者合理使用急救医疗资源;加强"供给侧"建设,继续完善医疗服务体系,畅通患者分流路径;加强物价和医保支付等政策支持;加强急救能力建设,完善及落实急诊相关规范。

The current situation of emergency medical care in Shanghai municipal hospitals was learned by literature review, questionnaire survey, key informant interviews and focus group discussion. It shows that the most serious problem is emergency entrance disorder and lack of export. The reasons include social factors, incomplete healthcare system, insufficient of incentive effect by medical service price and medical insurance payment system, lack of well-established emergency specification and difficulties to implement them. It is considered that the government should promote emergency legislation, clear the rights and obligations of stakeholders in emergency medical care, strengthen information disclosure, encourage patients rational use emergency resources, strengthen the construction of the ＂supply side＂, improve the medical service system continuously, promote patients diverting, strengthen prices and medical insurance payment policy support, strengthen the construction of emergency ability and improve emergency care regulation.