论文部分内容阅读
2008年厦门市启动医改,分级诊疗改革先后经历了三个不同的版本:1.0版本主要着眼于医疗集团化;2.0版本主要着眼于慢性病防治医院-社区一体化管理,先后形成了“1+1+x”模式和“1+1+1”即“三师共管”模式;3.0版本重点在于将分级诊疗进一步普及化,也就是覆盖健康人群,逐步探索建立“家庭医生”制度。本文从制度变迁视角考察了这三个版本演变的路径,并结合制度供给与需求两个维度进行分析,最后从四个方面归纳厦门分级诊疗模式成功的原因。通过梳理厦门市医改实践过程,有助于我们加深对分级诊疗改革所面临的难题以及解决思路的理解。
In 2008, Xiamen City launched the medical reform, and the grading reform has undergone three different versions: the 1.0 version focuses on the medical grouping; the 2.0 version focuses on the chronic diseases prevention and control hospital-community integrated management and has successively formed the “1 + 1 + x ”mode and “ 1 + 1 + 1 ”that is,“ three co-management ”mode; 3.0 version focuses on the further popularization of grading treatment, that is, covering healthy people, and gradually explore the establishment of“ family doctor ”system. This paper examines the evolution path of these three versions from the perspective of institutional change, and analyzes the two dimensions of system supply and demand. Finally, the paper summarizes the reasons for the success of Xiamen hierarchical medical treatment model from four aspects. By combing the practice of medical reform in Xiamen City, it helps us to deepen our understanding of the problems we face in grading the reform of medical treatment and treatment and how to solve the problem.