分级诊疗背景下成都市不同圈层医疗资源分布与利用分析

目的:通过分析成都市三圈层医疗资源分布与利用的历年变化情况,探讨分级诊疗政策的效果以及影响因素,为促进该市分级诊疗政策的有效实施提供政策建议。方法:利用近年四川省卫生统计年鉴等数据,以三个圈层人口医疗机构数以及总诊疗人次、院均诊疗人次、诊疗人次相对比作为分析指标,进行相应统计学分析。结果:成都市医疗资源分布呈"波浪形",优质医疗资源分布尤为不均衡;各圈层间医疗资源利用程度差异明显,第二圈层利用度相对最低;医疗机构间资源利用度不平衡,基层医疗卫生机构"受冷落"加剧;成都市分级诊疗实施效果有待提升。建议:在优化顶层设计、转诊激励机制、基层医疗服务能力、信息化建设等问题的基础上,结合成都市实际情况,进一步规范各级医疗机构功能定位,将中心圈层和第二圈层的医疗资源统筹合并发展,深化打造第三圈层"县域龙头"和"健康守门人",进一步推动"小病就近看,大病不出县"的实现。

Analysis of Distribution and Utilization of Medical Resources in Different Layers of Chengdu Under the Background of Graded Diagnosis and Treatment

Objective To analyze the changes in the distribution and utilization of medical resources in the three layers of Chengdu,and to discuss effects of the graded diagnosis and treatment policies and the influencing factors,so as to provide policy recommendations to promote the effective implementation of the city’s grading diagnosis and treatment policies.Methods Based on the data of Sichuan Provincial Health Statistics Yearbook in recent years,the number of medical institutions,population,the total number of medical treatments,the average number of medical treatments,and the relative proportion of medical treatments in the three-layer of Chengdu were used as analysis indicators to analyze the corresponding statistics.Conclusion The distribution of medical resources in Chengdu is"wave-shaped".The distribution of high-quality medical resources is particularly uneven.The degree of utilization of medical resources varies greatly among different layers.The utilization of medical resources among medical institutions is not balanced.The degree of utilization of medical resources in the second layer is relatively low,and the primary health care institutions are"cold down"increasingly,and the implementation effect of the graded diagnosis and treatment in Chengdu needs to be improved.Advice On the basis of optimizing top-level design,referral incentive mechanism,primary medical service capability,and information construction,and combined with the actual situation of Chengdu,the government should further standardize the functional positioning of medical institutions at all levels,and integrate the medical care of the central layer and the second layer.Besides,the third-layer"county leading"and"healthy gatekeepers"will be deepened,and the realization that"small diseases will be seen in local and the disease will not be treated out of the county"will be further promoted.