中国全科医学2018，Vol.21Issue(10)：1167-1176,10.DOI:10.3969/j.issn.1007-9572.2018.10.006
我国各省市自治区的分级诊疗政策比较研究
Policies Associated with the Implementation of Hierarchical Medical System across Different Provinces of the Mainland of China: a Comparative Study
摘要
Abstract
Objective To compare the policies associated with the implementation of hierarchical medical system across different provinces (autonomous regions/municipalities) in the mainland of China,providing a reference for further development of hierarchical medical system.Methods By visiting the websites of the government and health and family planning commission of 31 provinces (autonomous regions/municipalities) in the mainland of China,people.cn,sina.com.cn and other official media websites,we collected the documents and news reports associated with the contents and implementation of hierarchical medical system.Moreover,by searching the databases of CNKI and Wanfang Data Knowledge Service Platform using the terms "hierarchical medical system and measure/policy",we enrolled the articles collected as of March 31,2017 in which policies and measures related to the implementation of hierarchical medical system across the 31 provinces (autonomous regions/municipalities) were studied in detail.Then the enrolled data were classified and summarized.Results Totaled 38 official policy documents and news reports,and 12 articles from databases were included.29 provinces (autonomous regions/municipalities) were found with a complete set of relevant policy documents.5 tasks (determination of the responsibilities of medical institutions at all levels,initial treatment in grassroots medical institutions,dual referral system development,reasonable medical resource allocation and sharing,healthcare informatization) and 12 measures were identified for the implementation of hierarchical medical system across different provinces.To be specific,the number of provinces (autonomous regions/municipalities) that determined the functions of medical intuitions at all levels,kinds of diseases should be managed by medical intuitions at all levels,details for improving the service capabilities of grassroots medical institutions,details for the development of contractual service system in grassroots medical institutions,details for referral procedure,details for perfecting the mechanism of interest distribution,details for accelerating the medical informatization was 19,5,26,28,19,8,28,respectively.Moreover,the number of provinces (autonomous regions/municipalities) that proposed to perfect the operation mechanism of grassroots medical institutions,facilitate the reform of medical insurance reimbursement patterns,improve the formation mechanism of medical service price,promote the integration and sharing of the regional medical resources,and improve the reasonable medical resource allocation mechanism was 3,29,25,15,17,respectively.Conclusion Although the prefect hierarchical medical system has not been developed in China,the implementation of this system is under way orderly in the 31 provinces (autonomous regions/municipalities).All the provinces (autonomous regions/municipalities) have basically similar ideas and methods for implementation of this system,which suggests that the pattern for implementation of hierarchical medical system can be developed based on the local conditions.关键词
分级诊疗/卫生政策/比较Key words
Hierarchical medical treatment/Health policy/Comparison分类
医药卫生引用本文复制引用
张奕,卢东民,陈亚萍,庄一渝,冯文明,沈建通,温秋月..我国各省市自治区的分级诊疗政策比较研究[J].中国全科医学,2018,21(10):1167-1176,10.基金项目
浙江省教育规划课题(2017SCG038、2018SCG037) （2017SCG038、2018SCG037）
浙江省医药卫生科研基金项目(2017ky648) （2017ky648）
浙江省教育厅自然科学研究计划项目(Y201635273) （Y201635273）
浙江省医药卫生科技计划项目(2018KY794) （2018KY794）
