分级诊疗制度建设的影响因素剖析及建议

Analysis and Suggestion on the Factors Leading to the Difficulty in the Construction of Hierarchical Diagnosis System

剖析我国的分级诊疗制度建设发现:基层医疗服务能力弱,缺少居民信任的好医生,留不住患者,这是分级诊疗制度建设艰难的最根本因素;大医院无序扩张形成对基层人才、患者的大量虹吸,但采取行政手段难以改变这种状况;医疗保障引导分级诊疗作用有限;医疗联合体促进分级诊疗难奏效;全科医生培养收效甚微等因素导致分级诊疗制度建设艰难。实现分级诊疗是一项庞大的系统工程,当前最根本的任务是要提高基层医疗服务能力。建议对基层医疗卫生体制进行大胆改革,努力建立有利于优秀人才扎根基层、有利于缓解居民看病难看病贵、有利于推动健康中国建设的新机制。

It believed that there were many factors leading to the unsuccessful construction of the hierarchical diagnosis system: the ability of primary medical service was weak, good doctors who were trusted by the residents were lack, and the inability to retain the patients, which was the most fundamental factor. The disorderly expansion of large hospitals formed a large number of siphons for grass-roots talents and patients, but it was difficult to change this situation by administrative means;the role of medical security in promoting grading diagnosis and treatment was limited;the promotion of hierarchical diagnosis system by medical consortia was not effective;the training of the general practitioner had little effect. The realization of hierarchical diagnosis system was huge system engineering. At present, the most fundamental thing was to improve the capacity of primary medical services, to carry out bold reform of the primary medical and health system, to establish good talents taking root at the grass-roots level. It was beneficial to alleviate the difficulty of the residents in seeing a doctor and to improve the new mechanism of building healthy China.