| 引用本文：余红星,冯友梅,付旻,等.医疗机构分工协作的国际经验及启示——基于英国、德国、新加坡和美国的分析[J].中国卫生政策研究,2014,7(6):10-15 |
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| 医疗机构分工协作的国际经验及启示——基于英国、德国、新加坡和美国的分析 |
| 投稿时间：2014-04-06 修订日期：2014-04-24 PDF全文浏览 HTML全文浏览 |
| 余红星1,2, 冯友梅3, 付旻4, 刘智勇2, 姚岚2 |
| 1.湖北医药学院附属东风医院 湖北十堰 442008;2.华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030;3.武汉大学 湖北武汉 430072;4.武汉市卫生和计划生育委员会 湖北武汉 430014 |
| 摘要:在界定医疗机构分工协作内涵基础上，本文描述了英国、德国、新加坡和美国四个国家开展医疗机构分工协作的现状，认为其有利条件包括合格的全科医生、严格的卫生资源配置、有效的社区首诊和双向转诊制度。分析医疗联合体、管理型保健以及全科医生签约政策调整对分工协作的影响，总结出国外开展医疗机构分工协作的经验和启示：门诊与住院服务是否需要分离，基层医疗机构的私有化模式，护理、康复类机构与医疗机构的分工协作，医院集团化与分工协作的关系，以及分工协作并不能解决医疗服务提供体系的所有问题。 |
| 关键词:医疗机构 分工协作 分级诊疗 |
| 基金项目:教育部博士点基金（博导类）（20110112110025） |
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| International experience on the division and cooperation among medical institutions and its implications for China：An analysis of the UK, Germany, Singapore and the US |
| YU Hong-xing1,2, FENG You-mei3, FU Min4, LIU Zhi-yong2, YAO Lan2 |
| 1.Affiliated Dongfeng Hospital, Hubei University of Medicine, Hubei Shiyan 442008, China;2.School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Hubei Wuhan 430030, China;3.Wuhan University, Hubei Wuhan 430072, China;4.Health and Family Planning Commission of Wuhan Municipality, Hubei Wuhan 430014, China |
| Abstract:Through defining the connotation of division and cooperation among medical institutions, this paper introduces the current status for division and cooperation among medical institutions of Britain, Germany, Singapore and USA. The advantages include excellent general practices, optimal health resource allocation, effective first treatment in community health facilities, and effective two-way referral. We analyzed the influence of some new policies on the division and cooperation among medical institutions such as medical association, managed care and the General Practices' service contract. This provided a lot of experience and revelations, including the dynamics to promote the division and cooperation, the separation of outpatient services and inpatient services, privatization of primary medical institutions, division and cooperation between medical institutions and nursing, rehabilitation institutions, distinguishing the division and cooperation from hospitals alliance, and division and cooperation among medical institutions can not resolve the all issues in the medical care supply system. |
| Key words:Medical institutions Division and cooperation Bottom-up cascading healthcare practice |
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