基于协同治理的县域医疗卫生服务体系整合模式研究——以福建省建阳“三体一盟”为例

Research on the County Region Medical and Health Service System Integration Based on the Theory of Collaborative Management:Through Taking Jianyang County,Fujian Province as an Example

目的对福建省建阳医疗卫生服务体系的整合模式及效果进行分析,探究县域医疗卫生体系整合的关键要素。方法以协同治理理论为框架,从组织结构、服务模式、管理制度、信息技术等方面研究建阳医疗卫生体系的整合实践。结果医联体有效整合县域医疗服务、公共卫生和医疗保障体系,以医疗费用、医疗收入和医疗服务能力为判定标准的效果初显,并建立了一套相对完善的运行管理机制。结论网络与协作是推进县域医疗卫生资源整合的关键结构变量,需从利益、制度和信息技术等方面深化协作机制,促进整合功能发挥。

Objective Through analyzing the integration model and its effect,to explore the important factors of county medical and health service system integration.Methods Analyzing the operation practice from organization structure,service model,management system and information technology based on collaborative governance.Results The medical alliance effectively integrated the county medical service,public health and medical insurance system.The effect of this new model based on medical expenses,medical income and medical service capacity was obvious,and a set of more mature mechanism was established.Conclusion Network and collaboration are important factors of improving county medical service integration.It is necessary to deepen the cooperation mechanism from the aspects of benefit,system and information technology.