中国全科医学2017，Vol.20Issue(22)：2683-2690,8.DOI:10.3969/j.issn.1007-9572.2017.22.001
我国基层卫生综合改革进展
Progress of Comprehensive Reform of Primary Health Care in China
摘要
Abstract
This paper systematically reviewed typical practices and experience of the comprehensive reform of primary care in the whole country from 2009 to 2016,focusing on the innovation management system,financial compensation mechanism,personnel system reform,human resource management,performance allocation and assessment mechanism,performance appraisal mechanism,contracted services of general practitioners,primary health care workers system and development system of rural doctors in China.Analyzing data from China Health and Family Planning Statistical Year Book 2010-2017,National Financial Annual Report of Health Service 2009-2016 and survey data of contacted areas of primary care comprehensive reform 2014-2016,obvious achievements of comprehensive reform of primary health care have been shown as following.(1) The network of primary health care workers has been improved.(2) The number of primary health care workers has increased to a certain scale.(3) Quantity of primary health care services is increasing year by year in a more efficient manner.(4) The drug proportion as the whole revenue has been reduced and the cost of drugs has been reasonably controlled.(5) Patients and primary health care workers are more satisfied with primary health care system.However,challenges and problems exist.Firstly,the progress of comprehensive reform of primary health care in different areas is unbalanced.Secondly,the lack of sufficient services of primary care workers and the rapid development of hospital have a negative impact on comprehensive reform of primary care.Thirdly,the lack of talents in primary care system has become a bottleneck restricting the development of primary care system.Fourthly,multi-channel compensation mechanism needs further improvement.Fifthly,human resource management system is not sophisticated yet.Sixthly,essential drugs in primary care system can not meet the demand.Based on above analysis,this paper puts forward eight suggestions as follows.(1) Continuing to strengthen the primary care system.(2) Enhancing the competency of primary care services.(3) Innovating the primary care management system.(4) Establishing multi-channel compensation mechanism.(5) Further deepening the reform of the personnel system.(6) Improving the performance allocation and assessment mechanism.(7) Promoting contracted services of family doctors.(8) Establishing information support system for primary care.It is expected that these suggestions can provide the reference for a new round of comprehensive reform of primary care.关键词
基层卫生综合改革/补偿机制/激励分配机制/家庭医生签约服务Key words
Comprehensive reform of primary health care/Compensation mechanism/Incentive allocation mechanism/Contracted services of family doctors分类
医药卫生引用本文复制引用
秦江梅,张丽芳,林春梅,张艳春..我国基层卫生综合改革进展[J].中国全科医学,2017,20(22):2683-2690,8.基金项目
中国-世卫组织2016-2017双年度项目(201554356) （201554356）
