我国分级诊疗制度实施现状及问题分析

Analysis of Status Quo of Implementation of Classified Diagnosis and Treatment System in China

目的分析我国分级诊疗政策的实施现状,探讨分级诊疗实施过程中存在的问题并提出政策建议。方法运用我国2015—2017年《中国卫生和计划生育统计年鉴》中有关医疗服务机构、卫生服务情况的相关数据。结果截止2016年底,我国医疗卫生机构总数达983 394个,床位数为741.05万张,比去年增加39.53万张。我国医疗卫生机构总诊疗人次达79.32亿人次,居民平均就诊次数为5.7次,医疗卫生机构总入院人数为22 728万人,居民年住院率呈持续增长趋势。医疗卫生机构病床周转次数为32.0次,病床位使用率为79.8%。结论基层医疗机构发展相对医院速度较慢,整体上分级诊疗制度尚未促进基层医疗机构的发展,建议优化卫生资源配置,加强分级诊疗制度的宣传,畅通转诊机制。

OBJECTIVE To analyze the status quo of implementation of grading diagnosis and treatment policy in China, to discuss the problems existing in the implementation of grading diagnosis and treatment, and to put forward policy recommendations. METHODS Use relevant data on health service organizations and health services in China’s Statistical Yearbook of Health and Family Planning（2015—2017）. RESULTS Up to 2016, the total number of medical and health institutions in China reached to 983 394 and the number of beds was 7 100 500, an increase of 395 300 over last year. The total number of visits to medical and health institutions in China reached 7.932 billion person-times, the average number of visits by residents was 5.7 times, and the total number of people admitted to medical institutions was 227.28 million. The annual hospitalization rate of residents continued to increase. The number of hospital beds in medical and health institutions was 32.0, and the bed utilization rate was 79.8%. CONCLUSION The development of basic medical institutions relative to the hospital was slow, and overall classification and treatment had not yet promoted the development of grass-roots level. It was recommended that the allocation of health resources should be optimized, the promotion of hierarchical diagnosis and treatment systems should be strengthened,and the mechanism of referral should be smooth.