| 引用本文：陈瑶,代涛,马晓静.医疗集团改革实施效果研究——以江苏省某市为例[J].中国卫生政策研究,2013,6(8):8-13 |
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| 医疗集团改革实施效果研究——以江苏省某市为例 |
| 投稿时间：2013-07-05 修订日期：2013-08-07 PDF全文浏览 HTML全文浏览 |
| 陈瑶1, 代涛1, 马晓静1 |
| 中国医学科学院医学信息研究所/卫生政策与管理研究中心 |
| 摘要:目的：以江苏省某市为例，分析公立医院改革试点中构建医疗集团的改革效果。方法：收集该市两个医疗集团内各级医疗卫生机构在改革前后（2009年和2011年）的相关数据，进行描述性统计分析。结果：实体整合医疗集团的各级医疗卫生机构床位控制和人力资源发展的程度均优于虚拟整合医疗集团；前者医院提供服务占集团内总服务量的比例增长较慢，医院医生更愿意向社区转诊患者；两个医疗集团医疗费用水平均低于全国平均水平。结论：实体整合的医疗集团更有利于优化资源配置，完善基本医疗保险制度对于促进分级诊疗有重要作用，但集团内激励约束机制尚未完全统一，与国际上一体化整合做法相比仍有差距；建议实体整合的医疗集团应建立利益共享的分配机制，虚拟整合医疗集团应加强契约关系；给予当地居民选择的权利，促进医疗集团之间的有序竞争。 |
| 关键词:医疗集团 改革 效果 |
| 基金项目:中澳卫生与艾滋病项目“深化医药卫生体制改革评价研究”；中央级公益性科研院所基本科研业务费“深化医药卫生体制改革监测与评价研究” |
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| The effect of medical conglomeration reform： A case study in Jiangsu Province |
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| Abstract:Objective: To analyze the effect of medical conglomeration of in public hospital reform. Method: Data of medical institutions in two medical conglomerations are collected and analyzed by descriptive statistics. Results: Control over human resources and the number of beds of entity integration is better than virtual integration. The ratio of services provided by hospitals as to total available services is increasing slowly. Doctors in hospitals prefer to referring to community health centers in entity integration Control of medical expenses in the two medical conglomerations is less than the national average. Conclusions: the medical conglomeration of entity integration is better for optimally allocating resources. The development of basic medical insurance system has important effect on diagnosis and treatment. However, unified incentive and restraint mechanisms have yet been established in entity integration. This is different from the international pattern. Suggestions: The medical conglomeration of entity integration should build a benefit sharing allocation mechanism, and virtual integration should enhance contractual relationships. Residents should also have the right to choose medical conglomerations. This will foster competition. |
| Key words:Medical conglomeration Reform Effect |
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