作　　者： (贾艳婷）; (方鹏骞）;

机构地区： 华中科技大学同济医学院医药卫生管理学院,430030

出　　处： 《中国医院》 2017年第9期8-11,共4页

摘　　要： 县域内分级诊疗制度建设对于满足县域内居民不同层次的医疗服务需求、实现"大病不出县"的目标具有重要的意义。经过实证研究,对江苏省句容市"市镇村卫生一体化管理的区域健康联合体模式"、湖北省宜城市"资源共享的医疗集团运行机制"和重庆市九龙坡区"县乡一体化的区域医疗联合体模式"进行分析和比较,了解到目前县域内分级诊疗在顶层设计、基层医疗资源利用、医疗费用控制等方面已取得一定进展,但基层服务能力不足、医保杠杆作用弱、基层用药目录限制、信息化建设落后是现阶段实现分级诊疗的主要障碍,应当从体制机制改革、县域医疗服务能力建设、三医联动协作以及分级诊疗信息平台建设等方面寻求突破。 The construction of the hierarchical diagnosis and treatment system in county is of great significance to meet the needs of the residents at different levels in the county. Through empirical research, the study deeply analyzed and compared ＂Regional Health Consortium Model of Township and Village Health Integration Management ＂ in Jurong City, Jiangsu Province, ＂ Resource-sharing Medical Group Operation Mechanism ＂ in Yicheng City, Hubei Province and ＂ the Regional Medical Service Model＂ in Jiulongpo District, Chongqing. The results show that county-level classification has made some progress in policy design, the utilization of primary health care resources and medical expenses control. Shortage of service capacity in primary health care institutions, weak health insurance leverage, grassroots drug-use directory restrictions, backward information construction are biggest obstacles to achieve the goal. It needs to reform the institutional mechanisms, enhance county medical service capacity, promote Tripartite System Reform and construct the hierarchical medical Information platform to seek a breakthrough.

关 键 词： 分级诊疗 县域医联体 医疗集团 三医联动