| 引用本文：梁超,尚文茹,李春新,等.基于彩虹模型的上海新城区级医院发展瓶颈及对策研究[J].中国卫生政策研究,2025,18(5):27-34 |
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| 基于彩虹模型的上海新城区级医院发展瓶颈及对策研究 |
| 投稿时间：2025-03-27 修订日期：2025-05-09 PDF全文浏览 HTML全文浏览 |
| 梁超1,2,3，尚文茹1,3，李春新1，韩璐4，朱建征1,3 |
| 1.上海交通大学医学院附属第六人民医院 上海 200233;2.南京师范大学 江苏南京 210023;3.上海申康医院管理研究所 上海 200233;4.复旦大学附属中山医院 上海 200032 |
| 摘要:目的 分析上海新城区级医院发展中存在的核心问题，并基于彩虹模型提出区级医院发展对策建议。方法 采用目的抽样法，在5个新城中选择卫生行政部门、市级医院、区域性医疗中心等16家单位的26位关键知情人士进行现场调研和深度访谈，运用主题框架法对调研资料进行分析。结果 宏观层面的规划布局与资源分配、中观层面的组织联动与合作竞争、微观层面的医疗服务与人才学科是影响区级医院发展的重要因素；区级医院存在现实发展路径与功能定位不相匹配、体制机制与医疗资源有效整合的需求不相匹配、专科发展与新技术引进不足、医疗人才缺乏与流失严重、政策扶持力度有限、标准不统一和转诊不畅等发展瓶颈。结论 建议加强系统整合，优化新城卫生资源规划布局，引导市、区两级医院错位发展；强化组织整合，完善合作和利益分配机制，加快紧密型城市医疗集团建设；优化服务整合，加快新技术应用，加强专科联盟建设；深化功能和规范整合，统筹人财物资源，夯实基础支撑。 |
| 关键词:上海新城 区级医院 彩虹模型 发展瓶颈 对策 |
| 基金项目:上海市卫生健康政策研究课题（2024HP69）；上海市第六人民医院健康联合体科研专项（lylht202321；1y1ht202407） |
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| Development bottlenecks and countermeasures for district hospitals in Shanghai new cities： Based on rainbow model |
| LIANG Chao1,2,3, SHANG Wen-ru1,3, LI Chun-xin1, HAN Lu4, ZHU Jian-zheng1,3 |
| 1.Shanghai Sixth People’s Hospital， Shanghai Jiao Tong University School of Medicine， Shanghai 200233， China;2.Nanjing Normal University， Nanjing Jiangsu 210023， China;3.Shanghai Shenkang Hospital Management Research Institute， Shanghai 200233， China;4.Zhongshan Hospital， Fudan University， Shanghai 200032， China |
| Abstract:Objective To analyze the problems and constraints in the development of district hospitals in new cities of Shanghai， and to provide suggestions for the development of district hospitals based on rainbow model.Methods Using the purposive sampling method， 26 key informants from 16 units of health administrative departments， municipal hospitals， and regional medical centers in 5 new cities were selected for on-site research and in-depth interviews， and the research data were analyzed using the thematic framework method.Results Macro-level planning layout and resource allocation， meso-level organizational linkage and cooperation and competition， and micro-level medical service and talent discipline are important factors affecting the development of district hospitals； there is a mismatch between the realistic development path and functional positioning， mismatch between the institutional mechanism and the demand for effective integration of medical resources， insufficient specialty development and introduction of new technologies， lack of and serious loss of medical talents， limited policy support， inconsistent standards and transfer of resources， and limited policy support. Limited efforts， non-uniform standards poor referral， and other development bottlenecks.Conclusions It is suggested to strengthen system integration， optimize the planning and layout of health resources in the new city， and guide the differentiated development of hospitals at the city and district levels； Strengthen organizational integration， improve the cooperation and benefit distribution mechanism， and accelerate the construction of close-knit medical consortiums； Optimize the integration of services， accelerate the application of new technologies， and strengthen the construction of specialty alliances； Deepen the integration of functions and norms， coordinate human， financial， and material resources， and solidify the basic support. |
| Key words:Shanghai new cities District hospital Rainbow model Development bottleneck Countermeasures |
| 摘要点击次数: 51 全文下载次数: 11 |
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