上海市分级诊疗成效、难点和问题分析

Analysis on effectiveness, difficulties and problems of hierarchical healthcare system in Shanghai

目前,我国医疗需求巨大且持续增长,大医院医疗服务供不应求,分级诊疗建设任重道远。总结了上海市目前分级诊疗政策的着力点和作用,并对实际落实效果和存在问题进行分析,发现上海市所施行的"1+1+1"家庭医生签约制度和社区慢病门诊制度对于引导居民就医选择、打通转诊通道具有显著意义,但在服务协同、医生资源下沉社区、家庭医生培养等方面尚存在需要进一步改进的空间。

With the huge and rapid increase of medical care demands in China,large hospital is still in short supply and hierarchical healthcare system still has long way to go.The key point and functions of hierarchical healthcare system in Shanghai have been summarized and the problems and effectiveness have also discussed.It shows that‘1+1+1’family doctor contract system and community chronic disease outpatient system in Shanghai have got great effectiveness on resident visiting selection and dual referral system,but it also needs to be completed in care coordination,health resources allocating to primary healthcare and family doctor training.