摘要
目前我国紧密型县域医共体政策运行面临困境,为深度剖析紧密型县域医共体政策运行中存在的困境,以米特—霍恩模型的六大因素:政策目标与标准、政策资源、组织沟通与运行活动、运行机构特征、运行环境以及运行者价值取向为框架进行分析,得出政策运行的困境包括:政策目标涉及范围较广,政策标准落实时间较长,卫生资源配置效率较低,医保支付指挥棒作用弱,分级诊疗上下转诊不畅,信息化建设契合度不高,基层医疗机构能力不足,“三医”联动协调程度低等。为解决紧密型县域医共体政策运行困境,提出建议:制定具体可行政策,优化配置医疗资源,实现信息互通共享,提高基层医疗能力,加强医保改革力度,从而推进紧密型县域医共体稳固建设与长效发展。
At present,the policy operation of compact county medical alliances in our country is facing difficulties.In order to deeply analyze the difficulties existing in the policy operation of compact county medical alliances,the six factors of Meter⁃Horn model were used as the framework for analysis,which were policy objectives and standards,policy resources,organization communication and operation activities,operating organization characteristics,operating environment and operator value orientation.The results showed that dilemmas of policy operation included a wide range of policy objectives,a long time for implementation of policy standards,low efficiency in the allocation of health resources,weak effect of medical insurance payment,and unsmooth referrals in the tiered system of diagnosis and treatment,unmatched information construction,insufficient capacity of primary health care institutions,and the low level of coordination between medical services,medical insurance and pharmaceuticals.In order to solve the dilemmas of policy operation of compact county medical alliances,the following suggestions were proposed to promote the stable construction and long⁃term development of compact county medical alliances.Specific and feasible policies should be formulated.The allocation of medical resources should be optimized.Information exchange and sharing should be realized.The primary health care capacity should be improved.The medical insurance reform should be strengthened.
作者
光心慧
王珩
薛俊军
李念念
王存慧
GUANG Xinhui;WANG Heng;XUE Junjun;LI Niannian;WANG Cunhui(School of Health Management,Anhui Medical University,Hefei 230032;Dean’s Office,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Graduate Work Department,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Organization Department of the CPC Party Committee,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《南京医科大学学报（社会科学版）》
2021年第6期533-537,共5页
Journal of Nanjing Medical University（Social Sciences）
基金
国家自然科学基金“基于RBRVS的县级公立医院医生绩效薪酬分配机制研究”(7177400)。
