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安徽省阜南县县域医共体建设成效分析
Performance of a medical consortium in Funan County, Anhui Province

作者:刘雪薇 许寒冰 崔倩倩 孔杨

单位:山东,滨州医学院

关键词:县域医共体;阜南县;基层医疗机构;医疗服务能力;效果

分类号:R197

DOI:10.3969/j.issn.2095-7432.2021.01.005

出版年,卷(期),页码:2021,11 (1):14-18

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摘要:

目的 分析总结安徽省阜南县县域医共体实施成效,以期为县域医共体深化改革及其他地区医共体推进提供借鉴。方法 收集阜南县历年的住院总费用、县域内外住院分布、住院补偿支出、新农合实际报销比、城乡居民实际住院补偿比等数据及相关政策文件进行描述性统计分析。结果 阜南县县域医共体整体运行状况良好,住院费用增长得到有效控制,患者住院负担减轻,居民“看病贵”得到有力缓解;县域内外就诊结构有待进一步优化,县域内医疗机构整体服务能力有待加强,基层医疗质量有待提高。结论 县域医共体改革初期,阜南县县内就诊、基层就诊情况等均显著改善,但持续性不强,后期出现回跌趋势。对此,应积极发挥医保基金的杠杆作用,强化县域内外就医、转诊的引导、筛选与管理,继续加强人才引进和培养力度,并严格督促跟踪问题整改落实情况,切实提高县域内及基层的医疗服务能力,推动阜南县县域医共体建设共心、共管、共利,实

现协作共赢。

英文摘要:

Objective To summarize the performance of a medical consortium in Funan County, Anhui Province, in an attempt to provide reference for further promoting the reform on medical consortium at county levels and in other regions. Methods Data and policies on total hospitalization costs, distribution of hospitalization within and outside the county, hospitalization compensation expenditures, reimbursement ratio under the New Rural Cooperative Medical Care system, and hospitalization compensation ratio of urban and rural residents in Funan County were collected for descriptive statistical analysis. Results The county-level medical consortium in Funan County was well performed. The growth of hospitalization costs was effectively controlled, the burden of hospitalization on patients was reduced, and the health care affordability was improved. The structure of health care facilities inside and outside the county should be further optimized. The overall service capacity of medical institutions in the county and the quality of health care in grassroots hospitals needed to be improved. Conclusions At the initial stage of the reform on the county-level medical consortium, the health care service in the county and in grassroots hospitals was improved significantly; however, the sustainability was unsatisfactory, and there was a downward trend. Therefore, the following solutions are suggested: exert the leveraging effect of medical insurance funds to strengthen the instruction, triage, and management of medical visits and referrals within and outside the

county; continue to strengthen talent training and development; strictly supervise and track the implementation of rectification of the existing problems; effectively improve the health care services within the county and at the grassroots levels; and promote the shared management and shared benefits of the medical consortium, thus achieving win-win collaborations.

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