| 紧密型医联体模式下全科医学科建设探索 |
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| 引用本文： | 张玉彩,谢春,香利强,林丹娜,冼俊芳,罗新乐.紧密型医联体模式下全科医学科建设探索[J].中华全科医学,2019,17(4):661-665. |
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| 作者姓名： | 张玉彩 谢春 香利强 林丹娜 冼俊芳 罗新乐 |
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| 作者单位： | 深圳市龙华区人民医院社管中心全科教研室, 广州 深圳 518109 |
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| 基金项目： | 广东省医学科研基金项目(A2017162) |
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| 摘 要： | 目的 探讨紧密型医连体模式下全科医学科的定位。 方法 通过对比分析国内全科医学科的发展和深圳市5家区属医院全科医学科的实际运行情况，探索紧密型医联体模式下全科医学科在组织架构、功能定位和学科发展方面的建设。 结果 我国全科医学科的发展主要依赖学科联盟，通过教学师资输出与师资培养在临床基地和实践基地间建立联系。紧密医联体模式下全科医学科发展可借用行政手段强力推进，有利于分级诊疗。2016年深圳市社康机构基本医疗服务人次占全市公立医疗机构门急诊总诊疗量的42.66%。选择在社区首诊的医保参保人数量863万，占全市参保人总数的70%。深圳市区属医院全科医学科在组织架构上多采用双重管理模式，即在业务上归属医务科等职能部门管理，行政上归属社区健康管理中心管理。全科医学科在功能定位上侧重于全科教学，着重于全科医学人才培养，为基层输送合格的全科医生。全科门诊是全科医生的主要带教场所，全科住院部适合收治多病共存、未分化疾病和教学患者，有利于全科医生对典型患者的系统学习。 结论 紧密型医联体模式有利于分级诊疗推进，该模式下全科医学科组织架构可采用双重管理，其功能定位为全科教学，其学科发展方向为多病共存患者照顾。
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| 关 键 词： | 紧密型医联体 全科医学科 学科建设 |
| 收稿时间： | 2018-08-12 |
Exploration of the construction of general medicine department under the close medical association |
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| Affiliation: | Teaching and Research Section of General Practice, the People's Hospital of Longhua District, Shenzhen, Guangzhou 518109, China |
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| Abstract: | Objective To explore the orientation of general medicine department under the close medical association. Methods Through the comparative analysis of the development of general practice in China and the actual operation of general practice in five district hospitals in Shenzhen, the author explored the construction of general practice in organizational structure, functional orientation and discipline development under the mode of close medical association. Results The development of general medical science in China mainly depends on subject alliance, and the relationship between clinical base and practice base is established by teacher output and training. Under the model of close medical association, the development of general practice can be strongly promoted by administrative means, which is conducive to hierarchical medical treatment. In 2016, the person-times of basic medical services provided by community health institutions in Shenzhen accounted for 42.66% of the total outpatient and emergency treatment of public medical institutions in the city. A total of 8.63 million people, accounting for 70% percent of the total number of people in the city, participated in medical insurance for the first time in their communities. In terms of organizational structure, general medicine department of Shenzhen district hospitals mostly adopt the dual management mode, namely, they are managed by functional departments such as medical department in business and community health management center in administration. In terms of functional orientation, the discipline of general practice attaches importance to the teaching of general practitioners, and focuses on the cultivation of general practitioners, so as to provide qualified general practitioners at the primary medical institutions. General outpatient department is the main teaching place for general practice doctors. General inpatient department is suitable for patients with multiple diseases, undifferentiated diseases and teaching, which is conducive to the systematic learning for general practice doctors. Conclusion The model of close medical association is conducive to the advancement of hierarchical medical treatment. Under this model, the organizational structure of general practice can adopt dual management. Its function is positioned as general practitioners teaching, and its discipline development direction is to care for patients with multiple diseases. |
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