完善社区卫生服务模式的保障机制分析

 
投稿时间: 2014-11-23  最后修改时间: 2014-12-05  摘要点击次数: 2054  全文下载次数: 2
 
引用本文:袁莎莎, 王芳, 李陈晨,等.完善社区卫生服务模式的保障机制分析[J].中国卫生政策研究,2014,7(12):43-49
袁莎莎1, 王芳1, 李陈晨1,2, 刘利群3, 周巍3, 傅济3, 刘伟3, 衡驰1,2
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 北京 100020;
2. 北京协和医学院 北京 100730;
3. 国家卫生和计划生育委员会基层卫生司 北京 100044
基金项目:国家卫生和计划生育委员会基层卫生司委托项目;中央级公益性科研院所基本科研业务费(13R0112)
 
 摘要:目的:分析典型地区社区卫生服务中心在转变社区卫生服务模式的过程中所涉及的主要保障机制.方法:采取目的抽样,选取社区卫生服务模式探索较早且具有代表性的北京市、上海市、郑州市、成都市共12家社区卫生服务中心进行现场调查.采用定性调查为主、定量调查为辅的方法.结果:社区卫生服务模式转变过程中主要涉及的保障机制可归纳为四类,即外部协同机制、人才队伍建设机制、激励机制和医保支持机制.上述四种机制的建设对全科团队服务、双向转诊、签约与预约服务等的开展起到了关键作用.结论:在社区卫生服务模式转变的过程中,应加强顶层设计、完善制度建设、创造有利条件;加快全科队伍建设步伐,完善社区卫生人才培养培训机制;完善以服务绩效为导向的激励机制,调动团队服务积极性. 
  关键词:全科团队|协同机制|人才培养|激励机制|政策保障
 
Analysis on guarantee mechanisms related to the improvement of community health service modes
YUAN Sha-sha1, WANG Fang1, LI Chen-chen1,2, LIU Li-qun3, ZHOU Wei3, FU Ji3, LIU Wei3, HENG Chi1,2
1. Center for Health Policy and Management, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China;
2. Peking Union Medical College, Beijing 100730, China;
3. The Department of Primary Health, National Health and Family Planning Commission, Beijing 100044, China
 
 Abstract:Objective: To analyze the concerning guarantee mechanisms during the transformation of the community health service mode. Method: Purposive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou, and Chengdu, where the transformation of the community health service mode was piloted earlier and representative, were selected as the field survey sites. The qualitative method was used to collect data accompanied by the quantitative method. Results: The guarantee mechanisms related to the transformation of the community health service mode could be concluded into four main types: collaboration mechanism, health professional training mechanism, incentive mechanism, and policy guarantee mechanism. All of the four mechanisms contributed to the improvement of general teamwork, dual referral systems, and the development of contract and appointment services. Conclusion: During the transformation of the community health service mode, priority strategies include top-down design, health professional training mechanisms, and performance-based incentive mechanism, all of which should be implemented in the future. 
 keywords:General practice team|Cooperation mechanism|Health professional training|Incentive mechanism|Policy guarantee mechanism