以社区为导向的初级卫生保健：比利时社区卫生服务案例分析及启示

比利时的社区卫生服务模式对我国社区卫生服务改革具有借鉴意义。在对比利时一家典型的社区卫生服务中心进行现场考察和案例研究的基础上，总结了其开展社区卫生服务的做法：虽然存在缺乏首诊制度和沟通协调方面的问题，但以社区为导向的多学科协同服务和按人头付费的支付方式改革等做法成效显著。针对我国社区卫生服务改革中存在的问题，提出相关的政策建议，包括建立和完善法律、政策和制度设计；加强多学科的服务团队建设，推动医学模式在社区转变；完善医保配套政策支撑与激励；以社区需求为导向开展跨部门行动，引导社会资源整合。

Community oriented primary health care: A case study from Belgium community health service and its implications to China

Belgium＇s experience with community health is a valuable reference for primary health care reform in China. In this paper, we give an account of the practices we observed during a study visit to a community health center in Belgium. Belgian primary health care lacks a first diagnosis system and does have some communication and coordination problems. However, reform of community-oriented, multidisciplinary services and capitation payment has generally been effective. Vie also make policy recommendations for community health reform in China. Vie sug- gest improving the design of policies and mechanisms, strengthening muhidisciplinary teambuilding, establishing sup- porting medical insurance policies, and effectively allocating social resources according to the needs of local commu- nities.