湖州市城市医疗联合体建设实践

Practice of the construction of urban medical alliance in Huzhou city

推动医疗资源均衡布局,实现城乡基本医疗服务优质共享,是共同富裕的重要内容。湖州市城市医疗联合体(以下简称医联体)是基于四级纵向整合的新型城乡医联体模式,在整个医联体演进历程中,扮演着承上启下的重要角色,不仅突破了"县域一体",还探索了"市域一体",是联通县域和市域的桥梁,对缩小城乡医疗卫生服务差距具有重要意义。湖州市城市医联体建设以数字化转型和系统化集成为两大突破口,全面推进健康治理能效升级和效益叠加。2021年全市基层就诊率和县域就诊率分别为72.7%和90.6%,2020年公立医院住院均次费用(8726.7元)和门急诊均次费用(239.6元)分别比浙江省平均水平低25.0%和8.6%。虽然湖州市突破行政区划限制积极推进城市医联体建设取得了阶段性成效,但依然存在结构缺陷和体制困境的问题,建议通过"三治"和"三性"来推动治理结构完善和治理体制优化,进而推动城市医联体高质量发展。

Promoting balanced distribution of medical resources and realizing high-quality sharing of basic medical services between urban and rural areas are an important part of common prosperity.Huzhou urban medical alliance was a new urban and rural of medical alliance mode based on level 4 vertical integration,which played an important role in the whole evolution process of the medical alliance.This medical alliance had not only broken through the"integration of counties"but also explored the"integration of cities".It was a bridge connecting counties and cities,which was of great significance in narrowing the gap between urban and rural medical health services.The construction of urban medical alliance took digital transformation and systematic integration as two breakthroughs to comprehensively promote the upgrade of energy efficiency and benefit stacking of health governance.In 2021,the grass-roots medical utilization rate and county-level medical utilization rate were 72.7%and 90.6%.In 2020,the average hospitalization cost(8726.7 yuan)and the average outpatient and emergency expenses(239.6 yuan)of public hospitals were 25.0% and 8.6% lower than the average level of Zhejiang Province,respectively.Although Huzhou city had broken through the restrictions of administrative divisions and actively promoted the construction of the medical alliance,and achieved phased results,there were still structural defects and institutional difficulties.In order to solve these problems,the author proposed to promote the improvement of governance structure and optimization of governance system through"three governance"and"three characteristics",and then promote the high-quality development of urban medical alliances.