福建三明医防融合实践:局限与对策

Studying on the Limitations in Practice of Medical and Prevention Integration in Sanming City of Fujian Province and Its Countermeasures.

三明市医防融合改革源于医疗集团重医轻防以及三明市疾病预防需求增加的现状,通过预防与卫生健康网络的纵向融合、医疗与预防体系的横向融合、完善医疗与预防融合的政策支持三举并行,三明市已初步搭建起医防融合的桥梁。但改革面临着监督考核“缺位”、政府管控“越位”与协同机制“错位”的三重悖论,通过构建利益共同体能够有效化解悖论,可通过强化政策执行监督、放权与赋权并举以及完善医防协同机制的路径实现优化。

The reform of integration of medical and prevention in Sanming City originated from the current situation of medical group’s emphasis on medical treatment over prevention and the increasing demand for disease prevention in Sanming City.Through the vertical integration of prevention and health networks,the horizontal integration of medical and prevention system,and the improvement of policy support for the integration of medical and prevention in parallel,a bridge for the integration of medicine and prevention has been initially built in Sanming City.However,the reform is facing with the three paradox of“absence”of supervision and evaluation,“offside”of government control and“dislocation”of coordination mechanism,which can be effectively resolved through the construction of a community of interests,and optimized through strengthening the supervision of policy implementation,both decentralization and empowerment,and the improvement of the synergistic mechanism of medical and prevention.