构建紧密型医疗联合体的实践与探索

Practical Exploration of Building a Compact Medical Consortium

文章以上海市浦东新区大团社区卫生服务中心与上海市浦东医院建立紧密型医疗联合体为例,阐述了双方的合作背景、合作方式、合作成效。同时也发现,由于利益均衡机制不健全、医疗信息平台不共享、专家下沉社区动力不足、全科医生生存压力不足等问题,阻碍了紧密型医疗联合体的建设成果。建议通过加强顶层制度设计,健全长效激励机制;加强信息平台建设,实现互联互通和共享;突破编制薪酬制度,探索线上全科医生与专科医生联合门诊;引入内部竞争机制,倒逼全科医生利用医疗联合体资源等机制,建立多要素整合、多机制联动、多模式融合的紧密型医疗联合体。

Taking the establishment of a close medical consortium between Shanghai Pudong New Area Datituan Community Health Service Center and Shanghai Pudong Hospital as an example,the cooperation back ground,mode and effectiveness of the two.sides are expounded.At the same time,it is also found that the construction of close medical consortium is hindered due to the lack of motivation and survival pressure of general practitioners in the community,and the lack of medical information platform.It is suggested to strengthen the top-level system design,improve the long-term incentive mechanism,strengthen the construction of infor-mation platform,realize interconnection and sharing,break through the salary system,explore the joint outpatient service of online general practitioners and specialized doctors;introduce internal competition mechanism to force general practitioners to use medical association resources and other mechanisms to establish a close medical consortium with multi-factor integration,multi-mechanism link age and multi-mode integration.