我国分级诊疗理论架构、实现路径及评价体系

Theoretical framework,implementation path and evaluation system of the Tiered Diagnosis and Medical Treatment in China: a literature analysis

为构建我国分级诊疗理论框架、归纳其实现路径并总结其评价体系,本研究借助WHO卫生系统六模块等理论,结合实际对其进行总结梳理。研究发现,虽然各地各地区分级诊疗推进模式不尽相同,但实现路径殊途同归,都是在结构和过程中通过利益相关者的博弈更有效地配置医疗资源,最终实现首诊制的、整合性的、连续性的、减轻医疗负担的和让群众满意的诊疗服务。建议各地、各地区在综合评估卫生发展状况基础上有计划有步骤地推进分级诊疗,同时以史为鉴、参照国际经验,以弥补自身经验不足。

The aim of the study is to discuss the construction of the theoretical framework of the Tiered Diagnosis and Medical Treatment (TDMT) and to summarize the implementation path and evaluation system of TDMT in China. Relevant theories on TDMT such as six modules for health system recommend by World Health Organization (WHO) were used for references in the study. We found that although the promotion modes of the TDMT vary from place to place,the way to achieve the same goal is to allocate medical resources more effectively through stakeholder games in the structure and process of the TDMT,and ultimately achieve the first-visit,integrated,continual,less burden and more satisfactory health system. It is suggested that all regions should systematically promote the TDMT on the basis of comprehensive assessment of health development,draw lessons from history and refer to international experience so as to make up for the lack of experience.