基于国外分级诊疗模式探索我国分级诊疗实施措施

Exploration into implementation measures for the hierarchical medical system in China based on foreign hierarchical medical model

分级诊疗作为深化医药卫生体制改革的第一要务和重中之重,是居民良好有序就诊的保障。我国从2006年首次提出此设想模式,并且不断完善设想和进行推广,虽然许多政策措施对这个模式不断调整和优化,但实际效果并不理想且存在许多障碍。文章从分级诊疗的定义出发,结合国外一些相对成熟和完善的典型分级诊疗模式,分析当前我国推广分级诊疗制度遇到的壁垒和实际问题,包括居民对现有的基层医疗水平不信任;社区医院药品质量没有保证,基础医疗诊断设备不齐全,更新不及时;医院作为营利性机构,存在分工不清晰问题;社会医疗保险推动力较低。基于这些问题,文章提出相应的改进措施。

As the first and top priority for deepening the reform of the medical and health system, Hierarchical medical system is the guarantee for residents＇ good and orderly treatment. The model of grading diagnosis and treatment has been continuously improved and popularized since it was first proposed in China in 2006. Although many policies and measures have been constantly adjusted and optimized, the actual effect is not satisfactory and there are many obstacles. Based on the definition of grading diagnosis and treatment and the combination with some relatively mature and perfect models of typical grading diagnosis and treatment in foreign countries, the paper analyzes the barriers and practical problems encountered in the current promotion of grading medical treatment in China. For example, residents do not trust existing grassroots medical care; The quality of medicines in community hospitals is not guaranteed, and also the basic medical diagnostic equipment is not complete and the update is not timely in community hospitals; The division of responsibilities between hospitals at all levels is not clear; and The promotion of social medical insurance is low. Based on these issues, the paper puts forward corresponding improvement measures.