欠發(fā)達(dá)地區(qū)醫(yī)療衛(wèi)生服務(wù)體系建設(shè)存在問(wèn)題及對(duì)策研究

袁迅　馬聰　劉麗　錢(qián)吉康

[摘要] 我國(guó)欠發(fā)達(dá)地區(qū)醫(yī)療衛(wèi)生服務(wù)體系建設(shè)存在衛(wèi)生資源人均總量不足、優(yōu)質(zhì)資源分布不均、分級(jí)診療政策執(zhí)行不佳、基層醫(yī)療機(jī)構(gòu)運(yùn)行低效、三甲綜合醫(yī)院服務(wù)負(fù)荷重、醫(yī)患矛盾突出等問(wèn)題。通過(guò)分析原因，提出充分發(fā)揮統(tǒng)一的醫(yī)改領(lǐng)導(dǎo)體系職能、明確各級(jí)醫(yī)療衛(wèi)生服務(wù)機(jī)構(gòu)功能定位、加強(qiáng)分級(jí)診療政策監(jiān)管、加強(qiáng)基層醫(yī)療服務(wù)能力建設(shè)、優(yōu)化專(zhuān)業(yè)公共衛(wèi)生機(jī)構(gòu)建設(shè)、全面推進(jìn)遠(yuǎn)程集中診療模式、完善醫(yī)療集團(tuán)運(yùn)作機(jī)制、積極實(shí)施家庭醫(yī)生簽約服務(wù)、新聞媒體正確引導(dǎo)等對(duì)策建議。

[關(guān)鍵詞] 醫(yī)療衛(wèi)生服務(wù)體系;欠發(fā)達(dá)地區(qū);政府政策

[中圖分類(lèi)號(hào)] R197 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1672-5654（2020）02（c）-0109-03

[Abstract] The construction of the medical and health service system in China's underdeveloped regions has insufficient total per capita health resources， uneven distribution of high-quality resources， poor implementation of hierarchical diagnosis and treatment policies， inefficient operation of primary medical institutions， heavy service load in tertiary hospitals， and prominent doctor-patient contradictions and other issues. By analyzing the reasons， it is proposed to give full play to the functions of the unified medical reform leadership system， clarify the functional positioning of medical and health service institutions at all levels， strengthen the supervision of hierarchical diagnosis and treatment policies， strengthen the building of primary medical service capabilities， optimize the construction of professional public health institutions， and comprehensively promote the remote centralized diagnosis and treatment model， improve the operating mechanism of medical groups， actively implement family doctors signing services， the correct guidance of the news media and other countermeasures and suggestions.

[Key words] Medical and health service system; Less developed areas; Government policy

黨的十八大提出了2020年全面建成小康社會(huì)的宏偉目標(biāo)，醫(yī)療衛(wèi)生服務(wù)體系的建設(shè)與發(fā)展在新的歷史時(shí)期面臨新的歷史任務(wù)，要在“病有所醫(yī)”的基礎(chǔ)上持續(xù)取得新進(jìn)展，實(shí)現(xiàn)人人享有基本醫(yī)療衛(wèi)生服務(wù)。《全國(guó)醫(yī)療衛(wèi)生服務(wù)體系規(guī)劃綱要（2015—2020年）》提出了促進(jìn)我國(guó)醫(yī)療衛(wèi)生資源進(jìn)一步優(yōu)化配置，提高服務(wù)可及性、能力和資源利用效率，各地要科學(xué)、合理地制定實(shí)施區(qū)域衛(wèi)生規(guī)劃和醫(yī)療機(jī)構(gòu)設(shè)置規(guī)劃。

我國(guó)西部相對(duì)欠發(fā)達(dá)地區(qū)，醫(yī)療衛(wèi)生資源總量不足、質(zhì)量不高、分布不合理的問(wèn)題相較東部而言更加突出[1]。在新的歷史時(shí)期，欠發(fā)達(dá)地區(qū)醫(yī)療衛(wèi)生服務(wù)體系如何在醫(yī)改“深水區(qū)”將改革繼續(xù)扎實(shí)推進(jìn)，對(duì)此進(jìn)行研究，顯得十分具有必要性。

1? 欠發(fā)達(dá)……