基于SWOT模型分析下天津市医联体模式实施现状及对策研究

Study on the Implementation Situation and Countermeasures of Hospital United Systems in Tianjin Based on SWOT Model

目的:结合我国医疗卫生现状及相关政策分析天津市开展医联体工作的实施现状,为医联体模式在天津市全面开展提供理论依据,对医疗卫生服务体系整体格局平衡具有现实的指导意义。方法:目的性选取天津市16个建立医联体的三级医院和基层医疗机构的20名人员进行半结构式访谈,采用Colaizzi内容分析法将资料整理分析,应用SWOT模型,归纳总结出天津市医联体模式在实施过程中的优势、劣势、机遇和挑战。结果:天津市开展医联体的优势包括提高基层医生医务能力,应用信息网络搭建沟通平台,提升社区整体水平;劣势包括基层医生工作繁多、压力大、积极性不高,药品管理制度限制患者基层就医,医保制度限制医联体运行;机遇包括医联体建设有国家政策支持,设立专人专岗从事医联体工作;挑战包括基层缺乏吸引人才的机制、区域发展不平衡、缺乏统一管理。结论:天津市医联体模式在实施过程中应加强用经济激励医务人员积极性、建立医联体统一管理制度、完善相关医保政策和药品管理制度,维持医疗卫生服务体系整体格局平衡,促进天津市医联体的全面开展。

Objective Combining the current medical and health status and relevant policy analysis to carry out the implementation of hospital united systems,in order to provide a theoretical basis for the comprehensive development of hospital united systems in Tianjin,and has practical guiding significance for the overall pattern of the medical and health service system.Methods Twenty medical staff of the sixteen hospital united systems pilot units in Tianjin were purposive selected for semi-structured interviews,and the data were analyzed and summarized by Colaizzi content analysis method and SWOT model.Result The advantages of developing hospital united systems in Tianjin include promoting training for primary care physicians,using information networks to build communication platforms,and improving community level;The disadvantages of developing hospital united systems include that the primary care physicians having a lot of work,high pressure,and low enthusiasm,drug administration system restricting patients to see primary care physicians,and medical insurance system limiting the implementation of the medical association.The opportunities include supported by national policies for the construction of the medical association,and setting up special person and position to take hospital united systems.The challenge of developing hospital united systems is the lack of a mechanism for attracting talent at the primary care level,the imbalance of regional development,and the lack of unified management of the medical association.Conclusion In the implementation process of hospital united systems in Tianjin,the enthusiasm of economically motivated medical personnel should be strengthened,and a unified management system for medical associations should be established to promote the development of hospital united systems in Tianjin and maintain the overall balance of the medical and health service system.