摘要
推动医疗服务高质量发展,需要重新审视分级诊疗。分级诊疗虽在基层医疗服务能力提升等方面取得一定进展,但总体效果并未彰显。无论是诊疗服务还是住院服务,民众选择医院而非基层医疗机构就诊的趋势没有得到根本改变。在以人民健康需求为中心的医疗服务高质量发展阶段,要提升作为分级诊疗根基的基层首诊占比,仍面临民众理性选择与偏好难改变的障碍。鉴于此,分级诊疗的未来之路可有三种走向:一是创造有利条件,激励优秀医生下基层,增强基层首诊的吸引力。二是深化“放管服”改革,以多元化办医促进医疗服务业分类协同发展来满足多层次、多样化医疗服务需求。三是分拆公立大医院,让其在重新布局、充分竞争基础上进一步发展。
To promote the high-quality development of medical services,it is necessary to re-examine the hierarchical medical policy.Although progress has been made in improving the primary medical service capacity,the overall effect of the hierarchical medical policy has not been highlighted.The trend of people choosing hospitals rather than primary medical institutions for medical treatment has not been fundamentally changed,both in diagnostic services and inpatient services.In the stage of high-quality development of medical services centering on people′s health needs,for the reason that people′s rational choices and preferences are difficult to change,it is hard to increase the proportion of primary diagnosis,which is the foundation of hierarchical medical system.In view of this,there are three directions for hierarchical medical policy.Firstly,we should create favorable conditions,encourage excellent doctors to go to primary medical institutions,and enhance the attraction of"primary diagnosis"at the grass-roots level;Secondly,we need to deepen the reform to streamline administration,delegate powers,and improve regulation and services,thus promoting the coordinated development of different medical services by encouraging the establishment of various medical institutions to meet people′s multi-level and diversified needs;Moreover,we should split the large public hospitals and let it develop on the basis of re-layout and full competition.
作者
高传胜
雷针
Gao Chuansheng;Lei Zhen
出处
《中州学刊》
CSSCI
北大核心
2019年第11期65-72,共8页
Academic Journal of Zhongzhou
基金
教育部人文社会科学研究规划基金项目“包容性发展与治理视角下非户籍人口市民化的突破路径研究”(19YJAZH018)
国家自然科学基金重点项目(71733003)子课题“高质量发展阶段国内区域价值链分工协作的行政障碍、激励机制与政策措施研究”
关键词
分级诊疗
医疗服务
高质量发展
社会政策
hierarchical medical policy
medical services
high-quality development
social policy
