我国医院与社区卫生资源互动整合模式与政策研究

通过系统归纳和描述了目前我国大型医院与社区医疗资源互动整合的几种典型模式：以政府推动为基础的模式,以社区为基础的模式,以医院为主体的模式,医院和社区双向配合的模式,以疾病管理为基础的模式和以资产整合为基础的模式等。分析了大型医院与社区医疗资源互动整合中存在的问题与面临的挑战：互动整合的法规制度不协调;互动整合存在利益冲突;分级医疗制度不完善;互动整合的运行机制不配套;医疗资源配置机制存在缺陷。提出了相关的政策建议：统筹规划,建立政府主导机制;明确权责,建立利益平衡机制;完善分级医疗服务制度,构建战略伙伴关系;发挥医院核心作用,形成资源共享机制;改善社区卫生服务质量,建立质量控制和监督评价机制;鉴于区域发展不平衡的现实,鼓励采取不同形式的互动整合模式。

Research on patterns and policy of hospital and community health resources interaction and integration in China

The paper systematically summarizes several typical patterns of health resources interaction and integration between hospital and community health center, including the pattern based on government, based on community health center, based on hospital, based on the cooperation between hospital and community health center, based on disease and healthcare management, based on assets reorganization, and so on. The challenges in health resources interaction and integration include that the regulations of the interaction and integration are uncoordinated, benefit conflicts are existed, medical services rating system is imperfect, the relative operation mechanism does not match the interaction and integration mechanism, and medical resources allocation mechanism has defects. Then we put forward some related suggestions, such as establishing government-sponsored mechanism, specifying the power and responsibility through establishing benefit balance mechanism, perfecting the medical services rating system, constructing strategic partnership between hospital and community health center, putting the hospital into the key role for forming the health resources sharing mechanism, improving community health service quality through establishing quality control and supervision mechanism, and adopting the corresponding interaction and integration patterns in different regions.