基层首诊推行困难的原因与政策建议——基于诊断树模型及“控制阀门”理论

Reasons and Policy Suggestions for Difficulty in Implementation of First-level Diagnosis at Primary Level——Based on the Diagnostic Tree Model and the “Control Valve” Theory

当前,基层首诊在各地实践中出现了推行困境。本文构建诊断树模型,对基层首诊困境的根本原因进行层层分解与深入分析,并基于卫生改革的“控制阀门”理论,从筹资、支付、组织、管制、行为五个方面,提出提高基层首诊绩效的政策建议。

At present,the first-level diagnosis at the primary level has encountered difficulties in implementation in various places.This article builds a diagnostic tree model,analyzes the root causes of the first-diagnosis dilemma at the primary level in depth.Based on the"control valve"theory of health reform,it proposes to improve the first-level diagnosis at the primary level from five aspects:financing,payment,organization,regulation,and behavior.Policy recommendations to improve the performance of the first-level diagnosis at the primary level are offered.