分级诊疗背景下区域医疗协同发展建设路径探讨:基于苏州工业园区供需方调研分析

Discussion on regional medical coordinated development implementation path under the environment of hierarchical healthcare system:analysis on demand and supply of Suzhou Industrial Park

目的:在分级诊疗背景下,以苏州工业园区调研为基础,探索区域医疗协同发展建设路径。方法:采用自制调查问卷,运用分层抽样和随机抽样方法,以苏州工业园区内居民及基层医生为调查对象,进行问卷调查。结果:当居民患小病或者常见病时,43%的居民选择社区卫生服务中心/站;居民对基层医院的服务满意度为68%,认为最应加强建设的医疗机构为社区医院。基层医生的职业发展诉求为提升专业能力、增加经济收入、改善工作环境和提高职业地位。结论:实现区域医疗协同发展,必须以满足患者需求和基层医生的职业发展诉求为前提,通过构建符合患者需求的分级诊疗路径、建立在职医生连续培养机制、完善区域单病种管理方案、创新新型疾病管理方式等综合手段进行顶层政策设计。

Objectives:To explore a regional medical coordinated development implementation path based on the investigation of demand and supply of Suzhou Industrial Park under hierarchical healthcare system.Methods:Residents and doctors in primary healthcare in Suzhou Industrial Park were selected by stratified random sampling to have an investigation of self-designed questionnaire.Results:It shows that 43%of investigated resident first select community healthcare institute when got less severe illness and the satisfaction rate with primary healthcare institute is 68%.It also shows that community healthcare institute is the most urgent institute whose capacity needs to be improved.The career development demands of primary healthcare are professional capacity improvement,revenue,work environment and social status.Conclusions:The preconditions of regional medical coordinated development are patient demands and primary healthcare doctor’s career development.Top level policy making needs to consider some important factors such as constructing patient requirement matched hierarchical healthcare system and continuous education system for doctors,completing regional single disease management and innovating disease management.