紧密型医联体模式下基层医疗服务能力评估: 以大鹏新区医疗健康集团为例

Evaluation of Primary Medical Service Capacity under the Compact Medical Association Model:a Case Study of Dapeng New District Medical Health Group

目的以深圳市大鹏新区为例,评估紧密型医联体基层医疗服务能力。方法基于资源基础理论和动态能力理论,构建医联体服务能力三维(广度、深度、层次)结构模型和评估框架,对大鹏新区医联体医疗服务能力进行分析,同时基于熵值法评估大鹏新区医联体医疗服务能力综合得分。结果2016年以来,大鹏新区医联体服务能力广度、深度、层次均呈现上升趋势,转诊患者数量持续增加,群众就医满意度持续提升。2017年-2021年,基于熵值法计算的大鹏新区医联体基层医疗服务能力综合得分呈现波动上升趋势。结论一是强化牵头医院带动作用,进一步优化配置新区医疗资源。二是鼓励上级医院人才下沉基层,长效提升基层卫生服务能力。三是完善大鹏新区医疗健康集团内部双向转诊规范,明确分工协作机制。四是以医保支付方式改革促进基层首诊和人才下沉。

Objective To evaluate the primary medical service capacity of a compact medical association by case study of Dapeng New District in Shenzhen.Methods Based on the resource-based theory and dynamic capability theory,the three dimensions(breadth,depth,hierarchy)structure model and evaluation framework of the medical association service capability were built,and the ability of the medical association service capacity of the Dapeng New District was analyzed,and the comprehensive score of the service capacity of the medical association was evaluated based on the entropy method.Results Since 2016,the breadth,depth and hierarchy of service capacity of the medical alliance in Dapeng New District had shown an upward trend,the number of referred patients had continued to increase,and the public's medical satisfaction had continued to improve.From 2017 to 2021,the comprehensive score of primary medical service capacity of medical association in Dapeng New District calculated based on the entropy method showed a fluctuating upward trend.Conclusion First,to strengthen the leading hospital's driving role to further optimize the allocation of medical resources in the new district.Second,to encourage the talents of the higher hospitals to sink to the grassroots,and to improve the ability of grassroots health services in a long-term.Third,to improve the two-way referral standard within the Dapeng New District Medical Health Group,and clarify the division of labor and cooperation mechanism.Fourth,to implement health insurance payment reform to promote first treatment in community and retain talents.