县域医共体的发展现状与问题分析

目的:对国内医共体典型的特点和存在的主要问题进行分析梳理。方法:以政府网站等为基础,对28个省份的典型医共体进行了筛选,并找出相关政策文件或信息。结果:研究共找出40个医共体典型,其中可获取相关政策文件的有10个;从构成来看,宁海县、无棣县等地医共体只包括公立医疗机构,当阳市、巩义市等地医共体同时包括公立和私立医疗机构;从支付方式来看,阜南县、天长市等地医共体为按人头总额预付,宁海县、阳曲县等地医共体则为传统总额预算。结论:部分医共体建设的可能尚处于概念状态,多医共体下按人头总额预付具有一定资金风险,相对独立的组织关系不利于基层医疗机构发展。医共体建设是县域卫生体制改革的重要举措,但需要谨慎前行。

Analysis in the Development and Problems of County Medical Alliance

Objective:To analyze the characters and main problems of typical county medical alliances in China.Methods:It selects typical county medical alliances from 28 provinces and collected relative politic documents or information mainly based on government websites and so on.Results:It selects 40 typical county medical alliances in total and 10 are available for politic documents.For structure,medical alliances in Ninghai County and Wudi County contain only public medical institutions,while medical alliances in Dangyang and Gongyi contain both public and private medical institutions.For insurance payment,medical alliances in Funan County and Tianchang are capitation prepayment.Medical alliances in Ninghai County and Yangqu County are global budget.Conclusion:Some county medical alliances are still in design.It is risky to implement global per capita budget.Independent relationship in county medical alliance is not good for the development of primary medical institutions.The implementation of county medical alliance is important measurement for county health system reform,which needs cautious.