| 摘要: |
| 目的 调查分析县域地区分级医疗服务体系构建及运行现状，挖掘影响分级医疗的不利因素，提出推进对策。方法 抽样调查全国11个国家级公立医院改革试点县县域内医疗资源和服务量的布局、患者就诊流向、医药费用及医保支出等情况，采用描述性统计方法、文献分析等方法对现况进行剖析。结果 县域地区分级医疗体系基本构建，但基层医疗机构人力资源配置待优化，医疗资源利用效率、服务能力不高，医保控费效果不显著，群众就医理念待更新，基层首诊、双向转诊、分级医疗运行状况不佳。结论 实现分级医疗应从优化县域医疗服务体系结构着手，优化县域资源配置，制订双向转诊标准，提升基层医疗机构服务能力，加强健康教育，构建高效运转的县域分级医疗服务体系。 |
| 关键词: 县域 医疗服务体系 分级医疗 现状研究 |
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| Current Situation of Building Hierarchical Medical Service System in County-level Areas in China |
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| Abstract: |
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Objective To analyze the the system construction and current situation of hierarchical medical system in county-level areas, and the disadvantages of hierarchical medical treatement to propose countermeasures. Method Randomly investigating the distribution of medical resource and service quantity, patients’ visit flow, medical expense and medical insurance expense in county-level areas in 11 national public hospitals. Using descriptive statistical method and literature analysis to do status analysis. Result The hierarchical medical system is generally built. But human resource allocation of basic medical institutions needs further optimization, medical resource utilization and service ability is low, the effect of medical insurance control isn’t significant, the concept of people’s visiting doctors needs innovation, and the first medical visit in basic level, two-way referral, hierarchical medical treatment isn’t good. Conclusion Hierarchical medical treatment should start from county-level medical service system, optimize county-level resource allocation, formulate referral standardization, improve basic medical institution service capacity, improve health education, and construct effective county-level medical service system. |
| Key words: county-level, medical service system, hierarchical medical system, situation analysis |
