基于管理协同理论的国内外医疗机构上下联动工作机制分析

连续性医疗服务的提供需要分级诊疗制度的实施,"上下联动"是实现分级诊疗的重要途径。通过文献研究并结合管理协同理论,对国内外医疗机构上下联动的协同机会识别、沟通交流、要素整合、序参量选择、信息反馈5大工作机制进行分析。研究认为,落实机构功能定位是各级医疗机构上下联动的基础;标准化、安全化的信息建设及监督反馈机制的建立有效促进医疗机构上下联动;按人头付费的医保支付方式引导医疗机构产生上下联动内在动力,有利于形成以健康为中心的一体化医疗服务体系。

Research on the vertical linkage mechanism of medical and health institutions in China and abroad based on Synergistic Management Theory

The provision of continuous medical service needs the implementation of hierarchical diagnosis and treatment system,and"vertical linkage"is an important way to realize hierarchical diagnosis and treatment.This paper uses literature research and based on synergistic management theory to analyze the five working mechanisms of synergy opportunity discerning,communication,factor integration,order parameter selection and information feedback of medical institutions at home and abroad.It is pointed out that the implementation of the functional orientation of medical institutions at all levels is the basis of the vertical linkage;standardized and secure information construction and the establishment of supervision and feedback mechanism play a positive role in promoting the vertical linkage of medical institutions;Per Capital Budget medical insurance payment mode guides the medical institutionstos produce the internal motive of the vertical linkage,which is helpful to promote the vertical linkage of the organization and form an integrated health-centered medical service system.