摘要
目的:研究江苏医联体背景下分级诊疗实施效果的核心影响因素.方法:通过构建医联体背景下的分级诊疗系统动力学模型,以基层首诊人次数为核心评价指标,通过对不同靶点进行干预,研究对基层首诊人次数产生的影响.结果:所选取的4个干预靶点对分级诊疗均有正向促进作用,对基层首诊人数提升效果由高至低分别为医疗资源下沉、基层医疗技术水平、医保差异化水平以及基层医疗服务价格.结论:为更好推动分级诊疗制度的发展,可重点从医联体建设方面入手:如促进优质医疗资源下沉、提升基层医疗机构服务技术水平、完善医联体内部的医疗、医药、医保工作联动机制和完善医联体成员间的利益共享机制等,逐步实现就医格局有序合理化.
Objective:To study the core influencing factors of the implementation of hierarchical diagnosis in the context of Jiangsu Medical Association.Methods:By constructing the dynamics model of hierarchical diagnosis under the background of medical association,the number of the first treatment at the primary level was taken as the core evaluation index.By intervening on different targets,it studied the influence on the core evaluation index.Results:4 selected intervention targets had positive effects on hierarchical diagnosis.The effects of increasing the number of primary medical consultations at the grass-roots level from the highest to the lowest are respectively the subsidence of medical resources,the technical level of primary medical care,the differentiation level of medical insurance and the price of primary medical services.Conclusion:In order to better promote the development of the hierarchical diagnosis,it might focus on the construction of medical association,including promoting the subsidence of high-quality medical resources,improving the service and technical level of grassroots medical institutions,improving the linkage mechanism of medical treatment,medicine and medical insurance within medical consortium,and improving the benefit-sharing mechanism among members of medical association to gradually realize the orderly rationalization of medical treatment.
作者
汤少梁
仇佳欢
姚玲
TANG Shao-liang;QIU Jia-huan;YAO Ling(School of Health Economics and Management,Nanjing University of Chinese Medicine,Nanjing,210023,China)
出处
《中国卫生经济》
北大核心
2021年第1期25-29,共5页
Chinese Health Economics
基金
江苏高校哲学社会科学研究重点项目(2018SJZDI074)。
关键词
医疗联合体
分级诊疗
基层首诊
系统动力学
medical association
hierarchical diagnosis
first treatment at the primary level
system dynamics
