杭州市公立医院综合改革对分级诊疗体系的支撑机制与PCIC模式研究

Supporting Mechanism of Comprehensive Reform of Hierarchical Diagnosis and Treatment System and the Practice of the PCIC Model in Public Hospitals in Hangzhou City

公立医院综合改革须打破"以医院为中心"的固有服务模式,发挥公立医院在分级诊疗体系中的主导作用。杭州市顶层设计公立医院综合改革措施,实现对分级诊疗的有效支撑,促进以人为本的一体化卫生服务(PCIC)的提供,在传统的上下联动的分级诊疗基础上,进一步实现纵向和横向的组织一体化、拓展跨学科和跨领域的专业协作。杭州市的实践是在微观层次优化公立医院内部运行机制,促进医院公益性回归、整合碎片化服务、提升医疗服务质量和促进医患互动;在中观层次实现不同层级医疗卫生机构间的协作,实现转型学习协作模式的多学科团队合作;在宏观层次促进了医药卫生体系向PCIC模式的分级诊疗服务发展的功能转变。

The comprehensive reform of public hospitals should break the inherent service mode of "hospital centered" and give full play to the leading role of public hospitals in hierarchical diagnon’s and treatment system. Toplevel designed comprehensive reform measures of the public hospitals are taken to support the hierarchical diagnosis and treatment of health care system,to promote People-centered and Integrated Health Care(PCIC) health services provision,to realize vertical and horizontal organization integration,and further to expand interdisciplinary professional cooperation,on the basis of traditional top-down linkage hierarchical diagnosis and treatment. Practice optimizes the internal operation mechanism of public hospitals at the micro level,by promoting public welfare,integrating fragmented services,improving the quality of medical services and promoting the interaction between doctors and patients;it also realizes the cooperation among different levels of health care institutions at the meso level,by realizing the multi-disciplinary team cooperation through the transformation learning cooperation(TLC) mode;as a result,promotes the health care system’s transformation to PCIC mode at the macro level.