我国分级诊疗理论架构、实现路径及评价体系.pdfVIP

中国公共卫生

2019年4

月第

35卷第

4期

Chin

J

Public

Health,

Apr

2019

Vol.35

No.4·497

·

•

综述

•

我国分级诊疗理论架构、实现路径及评价体系*

1111,2

陈柯羽，韩优莉，王亚东，孟群

【摘

要】为构建我国分级诊疗理论框架、归纳其实现路径并总结其评价体系，本研究借助WHO卫生系统六模块

等理论，结合实际对其进行总结梳理。研究发现，虽然各地各地区分级诊疗推进模式不尽相同，但实现路径殊途同

归，都是在结构和过程中通过利益相关者的博弈更有效地配置医疗资源，最终实现首诊制的、整合性的、连续性

的、减轻医疗负担的和让群众满意的诊疗服务。建议各地、各地区在综合评估卫生发展状况基础上有计划有步骤

地推进分级诊疗，同时以史为鉴、参照国际经验，以弥补自身经验不足。

【关键词】

分级诊疗；理论；路径；评价

中图分类号:R

122

文献标志码:A

文章编号:1001-0580(2019)04-0497-07

DOI:10.11847/zgggws1121947

Theoretical

framework,

implementation

path

and

evaluation

system

of

the

Tiered

Diagnosis

and

Medical

Treatment

in

China:

a

literature

analysis

**

CHEN

Ke-yu,

HAN

You-li,

WANG

Ya-dong,

et

al

(SchoolofHealthManagementandEducation,CapitalMedical

University,Beijing100069,China)

【Abstract】

The

aim

of

the

study

is

to

discuss

the

construction

of

the

theoretical

framework

of

the

Tiered

Diagnosis

and

Medical

Treatment

(TDMT)

and

to

summarize

the

implementation

path

and

evaluation

system

of

TDMT

in

China.

Relevant

theories

on

TDMT

such

as

six

modules

for

health

system

recommend

by

World

Health

Organization

(WHO)

were

used

for

references

in

the

study.

We

found

that

although

the

promotion

modes

of

the

TDMT

vary

from

place

to

place,

the

way

to

achieve

the

same

goal

is

to

allocate

medical

resources

more

effectively

through

stakeholder

games

in

the

structure

and

process

of

the

TDMT,

and

ultimately

achieve

the

first-visit,

integrated,

continual,

less

burden

and

more

satisfactory

health

system.

It

is

suggested

that

all

regions

should

systematically

promote

the

TDMT

on

the

basis

of

comprehensive

assessment

of

health

development,

draw

lessons

from

history

and

refer

to

international

experience

so

as

to

make

up

for

the

lack

of

e