基于医联体平台的上海市不同等级医院协作机制研究

Research on Collaboration Mechanism of Hospitals of Different Grade in Shanghai City Based on Medical Alliance Platform

目的通过理论推演和现场访谈,探讨加强医联体内部协作机制的具体路径,并为下一步配套政策出台提供参考。方法借鉴利益相关者模型和SWOT分析方法,从内部博弈和战略环境两个方面分析推进医联体建设的动力和阻力,并在此基础上建立基于不同功能定位的医疗机构内部协作基本概念模型。结果医联体建立和运行牵涉不同组织和个人,各方利益诉求相异、掌握资源不同、行为动机不一,唯有通过建立有效的利益平衡机制和充分的激励约束机制,才能形成集体理性的客观结果。结论具体建议:提高基层医疗卫生服务能力,加大医保支付方式改革,优化医联体内部诊疗流程,推进信息互联和资源共享,鼓励民营机构参与医联体组建。

Objective To study the definite steps for strengthening internal collaboration mechanism in medical alliance through theoretical deduction and interview survey. Methods Through stakeholders model and SWOT analysis method, analyzing the power and resistance from aspects of internal game and strategic environment,and then building the basic conceptual model on this basis. Results Medical alliance involves different organizations and individuals,and only estab. lishing the effective mechanism of balancing of interests and sufficient incentive constraint mechanism can play a greater role. Conclusion It is suggested to improve the ability of primary health care services, enhance the reform of medical insurance payment methods,optimize the internal medical treatment process,promote information interconnection and resource sharing,and encourage private institutions to participate in the establishment of medical alliance.