摘要
自"新医改"以来,国家颁布了许多推进分级诊疗制度发展的政策,但十几年来,"看病贵、看病难"仍是大众普遍关心的民生问题。所以近5年的政策在"强基层"方面提出了更细化的措施,并要求我国在多地开展分级诊疗试点。本文研究了典型地区分级诊疗试点效果不同的原因,通过试点进一步分析了制约我国分级诊疗推行的因素,患者对基层医疗机构的固有看法及就医文化、不同等级医疗机构之间的竞争关系、不完善的监督体系、缺乏信息化成为主要制约因素。针对这些问题,提出了一些切实可行的改革建议,其中包括扩大医疗财政投入、加强各级医疗机构间的合作关系、鼓励群众共同监督、多渠道引导患者就医选择、构建医疗信息库等。
Since the"new medical reform",China has implemented pilot programs of hierarchical diagnosis and treatment in many places. The reasons for the different effects on the pilots in typical areas are studied in this paper. Based on it,the factors that restrict the implementation of hierarchical diagnosis and treatment are further analyzed. The inherent view and medical culture of patients in primary medical institutions,competition between different levels of medical institutions,imperfect supervision system and lack of information connectivity become major constraints. In response to these problems,some practical reform proposals are put forward,including increasing fiscal investment on medical treatment,strengthening cooperative relations between hospitals,encouraging the people to jointly supervise,guiding patients to choose medical treatment through multiple channels and building a medical information database.
作者
李勇
张诗雯
苏杭
梁巧惠
吴凡
LI Yong;ZHANG Shi-wen;SU Hang;LIANG Qiao-hui;WU Fan(China Pharmaceutical University,School of International Pharmaceutical Business,Jiangsu Nanjing 211198,China)
出处
《中国药物评价》
2019年第6期406-410,共5页
Chinese Journal of Drug Evaluation
基金
教育部人文社科科学研究青年基金项目:促进我国分级诊疗制度建设的医疗资源合理配置改革路径研究(19YJC790070)
江苏省高校哲学社会科学指导项目:促进江苏分级诊疗制度建设的医保支付改革研究(2017SJB0052)
中国药科大学2019年大学生创新创业训练计划项目:医疗资源配置对我国分级诊疗的影响——基于患者就医选择视角的实证分析(201910316177)
关键词
分级诊疗
监督体系
资源配置
试点效果
Hierarchical diagnosis and treatment
Supervision system
Resource allocation
Effect of pilot
