医联体实践中的认知误区——兼论实现“健康中国”目标的关键

Cognitive Gaps in the Practice of Integrated Care System:The Key for Achieving the Goal of “Healthy China”

从伦理学的视角探讨我国医联体实践中存在的伦理问题,其中包括医联体的概念问题,以及医联体实践的后果或效用问题,并对医联体实践后果的解释进行了分析。进而,根据对上述问题的研讨结果,指出我国决策者在建立医联体上存在的认知误区。最后,指出解决"看病难、看病贵"问题,实现"健康中国"战略目标的关键是改造我国"支离破碎"的初级医疗系统,使之成为健全的基础医疗卫生系统,并将此置于整体医疗卫生工作的优先地位,唯有在此健全的基础医疗卫生系统基础上,才能使为特定目的建立的医联体发挥有效作用。

The author of this article first explores the ethical issues existed in the practices of integrated care system（ICS）from ethical perspective,including conceptual issues of ICS,and consequences or utility of the ICS practices,as well as various explanations of these consequences.Then on the basis of the findings of inquiry above,the author points out that there are cognitive gaps existed in Chinese decision-makings in building ICS.Finally,the author claims that for solving the problem of difficulty to visit doctor and unaffordability of medical care and achieving the strategic goal of Healthy China 2030,the key is to transform existing fragmented primary care system into a robust fundamental care system,and the priority of whole health undertakings should be put to it.Only on the basis of this robust essentially fundamental care system the ICS built for specific objective can play its effective role.