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我国分级诊疗制度实施的关键问题与对策探讨

Discussion on the Key Problems and Countermeasures of Implementing Hierarchical Diagnosis and Treatment System in China

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【作者】 方鹏骞蒋帅杨兴怡苏敏

【Author】 FANG Peng-qian;JIANG Shuai;YANG Xing-yi;School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology;

【机构】 华中科技大学同济医学院医药卫生管理学院;

【摘要】 实施分级诊疗制度是深化我国医药卫生体制改革的核心战略要求,其实质是在卫生、财政、医保、药品监督等多部门协同作用下,各层级医疗机构之间实现诊疗服务的科学性和连续性,形成预防、治疗、康复等有机整体,达到合理有序的就医格局。当前的分级诊疗制度存在分级诊疗体系建设不完善、基层首诊实现程度低、缺乏利益激励机制以及信息化程度不高等问题,对此提出相应的建设性对策,以实现分级诊疗制度的可持续推进。

【Abstract】 Hierarchical diagnosis and treatment system is the crucial strategic requirement of deepening health system reform to implement in China,and the essence of which is to achieve a reasonable and orderly treatment pattern under the synergistic effect of multi-sectoral coordination in health,finance,medical insurance,and drug supervision department,and scientifically and continuously provide medical services among different medical institutions.The organic integrity in prevention,treatment,rehabilitation and so on comes into being.Currently,the hierarchical diagnosis and treatment system has some key questions in the process of implementation:drawbacks in the design of the system,few patients’ primary diagnosis at the grassroots,lack of incentive mechanism in the system,and unconsummated medical informatization.Some constructive countermeasures come up in order to realize sustainable progress of the system.

【关键词】 基层首诊; 分级诊疗; 双向转诊; 利益机制; 信息化;

【Key words】 primary diagnosis at the grassroots; hierarchical diagnosis and treatment system; two-way referral system; interest mechanism; informatization;

【分类号】R197.323;

【基金】 国家社会科学基金重大项目(15ZDC037);美国中华医学会基金项目(CMB15-223)

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