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引用本文:张拓红,谢铮,杨辉,等.某市社区卫生机构与大中型综合医院的关系模式研究[J].中国卫生政策研究,2009,2(1):11-14
某市社区卫生机构与大中型综合医院的关系模式研究
投稿时间:2008-12-05  修订日期:2009-01-15  PDF全文浏览  HTML全文浏览
张拓红1, 谢铮1, 杨辉2, 任依1, 李小飞1
1.北京大学公共卫生学院;2.澳大利亚蒙纳仕大学初级卫生保健学院
摘要:目的:了解某城市社区卫生服务机构与大中型综合医院之间关系现状,探讨建立两者之间合理关系的策略。方法:文献研究、案例研究和关键知情人访谈。发现:我国医疗机构与行政管理级别对应,使得大医院和基层卫生服务机构之间关系松散,缺少联系;在发展和改革过程中,大医院和社区卫生服务机构之间的服务提供内容界定并不清楚;虽然出台了不少加强两者之间联系的政策措施,但这些新政策尚没有抓住关键环节。某市两类机构的关系主要有三种类型:大医院办社区、契约或托管、松散关系。研究表明,两者之间自身利益关系越密切,越能够顺利地实现相互联系,此外,还有很多方面会影响二者之间的关系。结论:需要明确两类机构的角色与功能,加大社区卫生服务的发展力度,特别是人才培养,在一定程度上限制大医院的规模;对于大医院办社区的模式,需要谨慎对待。
关键词:社区卫生服务机构  综合医院  关系  模式
基金项目:北京市哲学与社会科学基金(编号:06AaSH003)
Research on relationship between Community Health Services facilities and hosptials in uran area
ZHANG Tuo-hong1, XIE Zheng1, YANG Hui2, REN Yi1, LI Xiao-fei1
1.School of Public Health, Peking University;2.School of Primary Healthcare, Monash University
Abstract:Objectives: The research aims to understand the relationship between Community Health Services facilities and hospitals in the sample city Methods: Literature review, case study and key informant interview were applied Main findings: The health care facilities located in and administered by different administrative levels It resulted in loose relationship between hospitals and community health care providers The functions and roles for these two kinds of providers have not been clearly defined A number of new policies were developed to guide the two providers establishing a harmonious relationship However, it seems that these new policies have not touch the key problems There are three types of relationships between these two providers: 1) hospital managed community health care, 2) hospital contracted community health centers, 3)hospital doesn’t have any relationship with Community Health Services Therefore, a close relationship between these two providers depends on whether they can benefit to each other However, the government needs to determine carefully on whether it should support this type of relationship Conclusions: Roles and functions of different providers should be defined The development of the Community Health Services should be focused, especially the human resource development It is urgent to regulate and restrict the scale of the large hospitals
Key words:Community Health Services, General hospital, Relationship, Pattern
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