新医改环境下我国社区卫生服务发展的回顾与思考

回顾10多年的发展历程,我国社区卫生服务经历了试点、框架建立、机制建设和快速发展三个时期,当前呈现出发展速度快但不平衡、外延发展转向机制建设、基础建设加强但制度建设滞后的特点。在当前医药卫生体制改革的实践中,收支两条线是一种有益探索,但不是保证社区卫生服务公益性的唯一途径;基本药物制度和药品零差率政策的落实,需要相关配套政策的支持;医疗保险制度改革需要与社区卫生服务发展同步;鼓励社区卫生服务在满足群众基本卫生服务需求的目标下扩大服务范围;社区卫生人才培养滞后于社区卫生发展的状况应该及早改变。展望社区卫生服务的发展,要有信心,敢于创新,不急躁、循序渐进、夯实基础。

Review and reflection on the development of community health services in the context of new health system reform in China

China＇s community health services （CHS） have experienced 10 years development through 3 stages, i. e. , pilot project, framework construction, mechanism construction and rapid development. Although the CHS development is rapid at present, there are several problems such as unbalance development across different areas, de- notation development to mechanism construction, strong infrastructure building and weak system building. At present stage of health reform, the method of separating revenue and expenditure is a good exploration, but not the single one to ensure the CHS＇s nonprofit. To implement the policy of national essential medicines and zero margin drug profit need more complement policy to support it. And the health insurance system reform should go in hand with the CHS development. More health services should be provided except for the basic heahhcare service in CHS facilities. In addition, it is an urgent job to solve the human resources shortage in CHS. Finally, we are confident to look forward to the future development of CHS, and should strengthen the basic foundation in an innovative way.