医联体框架下各省市关于强基层举措的现状分析

Status Analysis of Primary health care strengthening in different provinces and cities under the framework of medical association

目的国内各省市陆续开展医联体框架的建设来加强基层医疗卫生服务水平。了解不同地区的不同做法,为更好落实分级诊疗制度提出意见建议。方法运用文献分析法,筛选有关医联体框架下强基层的文献,归纳后采用对比分析法,得出结论。结果总结得出以病人、核心医院、合作医院与政府四类不同角度下医联体工作推行当中面临的问题。各省市就实际情况也开展了如双向转诊绿色通道、优质医疗资源下沉等强基层的措施。结论目前全国医联体还处于探索模式,需要因地制宜的制度设计。通过医联体来加强基层医疗服务能力,从而达到基层首诊、双向转诊、上下联动、急慢分治的就医格局。

Objective The provinces and municipalities have carried out the construction of medical association framework to improve the primary health care service level. The major goal of this research is to better understand different practices in different areas, so that we could build up a better medical community framework and provide evidences for suggestions to the implementation of the classification system. Methods Literature analysis was adopted as the methodology in this research.The literature about the strong fundamental-level under the framework of medical association was searched and the conclusion was drawn by contrastive analysis. Results The author summarized that the problems facing the implementation of medical association under the four different perspectives including patients, core hospitals, cooperative hospitals and government. Provinces and cities also implemented several measures such as two- way referral green channel, spreading high-quality medical resources to the lower levels and other measures to enhance the fundamental-level depending on their own actual situation. Conclusion At present, the national medical association is still in the exploration mode. It appears that different regions have different difficulties,therefore, system design based on local conditions is necessary. The medical association is the best possible way of implementing the classification system of diagnosis and treatment of the construction. The medical association is also the key to strengthen the primary medical service capabilities, so as to achieve primary examination, two-way referral, up and down linkage, acute and slow sub- governance medical treatment pattern.