医联体建设与构建分级诊疗服务体系研究

Construction of medical alliance and the hierarchical medical service system

目的系统分析我国医联体政策的现状,为进一步完善我国分级诊疗政策提供参考依据。方法采用文献梳理法、综合评分法,梳理和归纳了我国27个省市区颁布的医联体的相关政策。结果部分省市区在分级诊疗政策出台之前就有医联体政策,但实施效果不佳。在综合评分方面以上海市、北京市、浙江省、江苏省较高,吉林省、西藏自治区、内蒙古自治区较低。结论医联体政策在各地实施的深浅不同,标准的设定较为混乱。用外部企业内部化的理论建议完善顶层设计,医疗机构加强规范和激励机制,患者加强自身教育,制定并推广签约医生等制度。

Objective To analyze systematically the current situation of China’s policies for medical alliances and to provide references for further improvement of China’s hierarchical diagnosis and treatment. Methods The related policies for medical alliances issued by 27 provinces and municipalities in China were sorted out and summarized by literature review and comprehensive evaluation. Results Some provinces and municipalities had promulgated policies for medical alliances before the introduction of the hierarchical diagnosis and treatment policy, but the implementation was not satisfying. The comprehensive scores of Shanghai, Beijing, Zhejiang Province and Jiangsu Province were higher, while those of Jilin Province, Tibet Autonomous Region and Inner Mongolia Autonomous Region were lower. Conclusions The implementations of medical alliance policies are quite different in different provinces and municipalities, and the established norms are also disordered. It is suggested to improve top-level design, strengthen medical institutions’ norms and incentive mechanisms, enhance patients’ self-education, and formulate and promote contracted doctor system.