分级诊疗制度下“医联体”模式实施现状及效果研究  被引量：32

作　　者：熊之潔 张炜[1] 杜小青[1] XIONG Zhi-jie(Accounting Department,Finance Department,West China Hospital,Sichuan University,Chengdu,P.R.China)

机构地区：[1]四川大学华西医院财务部会计科,四川成都610041

出　　处：《中国卫生事业管理》2020年第4期248-251,共4页Chinese Health Service Management

基　　金：四川省科技厅支撑计划项目“新医改背景下公立医院公益性回归路径及补偿机制的集对分析系统研究”(2017ZR0058)。

摘　　要：目的:探究分级诊疗制度下“医联体”模式实施情况,并对其效果和优化措施予以研究.方法:选择2016年9月至2017年9月X市X区医联体医院医务工作者49名,另选取同期X市X区居民483名,分别对上述人员实施约访和问卷调查,对当前各人群对分级制度下“医联体”模式了解程度、认同情况及制约其效果的相关因素予以分析.结果:不同性别、年龄、学历、工作岗位医务工作者对分级诊疗作用发挥认知情况无差异,认同医联体分级诊疗、认为双向转诊不到位的医务工作者对医联体模式分级诊疗作用发挥认同水平比例较高,组间具有明显差异.距离因素、医疗技术因素、医疗费用因素对居民选择首诊医疗机构造成重要影响.不同性别、年龄、学历、个人年收入居民对医联体模式分级诊疗认知情况无差异,有医疗保险、去过社区医疗机构、了解双向转诊、有双向转诊经历的居民对医联体模式分级诊疗认知比例较高,两者差异明显.结论:分级诊疗制度下“医联体”模式在实施中,基层首诊及双向转诊现状取得了一定成果,但在实施期间仍存在部分问题,对此,应加强政府宏观支持与帮助、明确医疗机构的功能定位、提升医疗机构的认知水平,从而推动医联体制供给侧改革成效,完善医联体模式应用效果.Objective To explore the implementation of the“medical association”model under the hierarchical diagnosis and treatment system,and to study its effect and optimization measures.Methods From September 2016 to September 2017,49 medical workers of X District Medical Association Hospital and 483 residents of X District of X City during the same period were selected to carry out interviews and questionnaires respectively.This paper analyzes the degree of understanding,the status of identity and the related factors that restrict the effect of the classification system.Results there was no difference in the cognition of medical workers in different sex,age,academic background and post to the function of grading diagnosis and treatment.It was considered that the proportion of medical workers who did not have the two-way referral to the classification diagnosis and treatment of the medical body model was higher and there was significant difference between the two groups.Distance factor,medical technology factor and medical cost factor had important influence on residents'choice of first-visit medical institution.There was no significant difference between the residents of different gender,age,educational background,and annual income.They had medical insurance,went to community medical institutions,and learned about two-way referrals.There was a significant difference between the two groups.Conclusion In the implementation of the "medical conjoined" model under the classified diagnosis and treatment system,some achievements have been made in the current situation of the first and two-way referral at the grass-roots level,but there are still some problems during the implementation period.In view of this,the government should strengthen the macroscopic support and help.In order to promote the effect of medical system supply-side reform and improve the application effect of medical conjoined mode,the function orientation of medical institutions should be defined and the cognitive level of medical structure should be impro

关 键 词：分级诊疗制度 医联体 实施现状 优化措施 

分 类 号：R-1[医药卫生]