本文選題：醫(yī)療聯(lián)合體　切入點：基本醫(yī)療衛(wèi)生服務(wù)　出處：《安徽大學(xué)》2014年碩士論文

【摘要】：生命健康權(quán)是不會因為種族、年齡、性別、經(jīng)濟水平和社會地位等方面的差異而存在高低貴賤之分,它是人類最基本的一項人權(quán),也是人類享有其他各種權(quán)利的基礎(chǔ)。為了保障人人都能獲得基本的生命健康權(quán),國家一直都在致力于醫(yī)療衛(wèi)生服務(wù)體系建設(shè)�，F(xiàn)階段,醫(yī)療衛(wèi)生事業(yè)隨著我國經(jīng)濟水平大幅提高有了較大的發(fā)展,而醫(yī)療技術(shù)水平也得到了明顯提升。然而由于多種原因,目前“看病難,看病貴”,醫(yī)患關(guān)系緊張,城市大醫(yī)院看病患者熙熙攘攘、人滿為患,而在基層社區(qū)醫(yī)院求醫(yī)問藥者冷冷清清的現(xiàn)象仍然十分嚴(yán)重。2009年4月6日中央政府發(fā)布的,中共中央、國務(wù)院在《關(guān)于深化醫(yī)藥衛(wèi)生體制改革的意見》明確指出：要完善以社區(qū)衛(wèi)生服務(wù)為基礎(chǔ)的新型城市醫(yī)療衛(wèi)生服務(wù)體系,建立城市大醫(yī)院與社區(qū)衛(wèi)生機構(gòu)的分工合作機制。由此從政策層面,國家給出了下一步醫(yī)療衛(wèi)生體制改革的目標(biāo),也為建立全民享有的基本醫(yī)療衛(wèi)生制度、漸進有序地達到人人享有的最基本醫(yī)療衛(wèi)生服務(wù)這一戰(zhàn)略目標(biāo)指明了方向。同時新型城市醫(yī)療衛(wèi)生服務(wù)體系的建立,有利于緩解目前困擾人們看病難、看病貴的社會現(xiàn)狀,縮小社會成員的城鄉(xiāng)差距和群體差異；有利于促進區(qū)域經(jīng)濟發(fā)展,保持社會穩(wěn)定和諧；更有利于全社會早日實現(xiàn)偉大的“中國夢”。 然而,在構(gòu)建新型城市醫(yī)療衛(wèi)生服務(wù)體系的過程中,如何促進城市大醫(yī)院與社區(qū)衛(wèi)生服務(wù)機構(gòu)之間的分工協(xié)作?幾級醫(yī)療機構(gòu)采取哪種協(xié)作方式?杭州市拱墅區(qū)衛(wèi)生局與杭州師范大學(xué)附屬醫(yī)院組建了醫(yī)療聯(lián)合體,為建立新型城市醫(yī)療衛(wèi)生服務(wù)體系進行了大膽的探索。本文綜合了國內(nèi)外醫(yī)療聯(lián)合體發(fā)展水平,系統(tǒng)的介紹了拱墅區(qū)醫(yī)聯(lián)體的建立和發(fā)展,以及在發(fā)展的過程中存在的問題,剖析了存在的問題原因,提出了相應(yīng)的解決方法。 文章一共有五個章節(jié)。第一章為緒論,提出了論文的選題及其目的、主要概念,包括公共產(chǎn)品、基本醫(yī)療衛(wèi)生服務(wù)、政府主導(dǎo)和醫(yī)療聯(lián)合體等概念的界定及其相關(guān)闡述、提出了主要觀點和研究方法以及本文可能的創(chuàng)新和不足之處等。第二章為文獻回顧,包括醫(yī)療聯(lián)合體在國外發(fā)展和醫(yī)療聯(lián)合體在國內(nèi)發(fā)展現(xiàn)狀。醫(yī)聯(lián)體在國外發(fā)展,主要介紹了在美國、英國、德國、巴西和印度等國發(fā)展的現(xiàn)狀；醫(yī)聯(lián)體在國內(nèi)發(fā)展,主要介紹了在北京、上海、湖北、江蘇鎮(zhèn)江和河南等地發(fā)展的現(xiàn)狀。第三章為醫(yī)療聯(lián)合體在杭州市拱墅區(qū)的發(fā)展的現(xiàn)狀,介紹了醫(yī)療聯(lián)合體在杭州拱墅區(qū)的建立、發(fā)展的現(xiàn)狀、發(fā)展和運行中存在的問題。第四章為醫(yī)療聯(lián)合體在杭州市拱墅區(qū)發(fā)展存在問題的原因分析,包括內(nèi)部協(xié)調(diào)不夠的原因分析、信息化建設(shè)存在問題的原因分析、病人在雙向轉(zhuǎn)診中存在問題的原因分析等。第五章為對存在問題的提出對策和建議。 本文認(rèn)為要構(gòu)建新型城市醫(yī)療衛(wèi)生服務(wù)體系,建立區(qū)域醫(yī)療聯(lián)合體,應(yīng)該由政府主導(dǎo),統(tǒng)籌規(guī)劃,建立各級醫(yī)療衛(wèi)生機構(gòu)的協(xié)作整合機制；要建立利益平衡機制,引導(dǎo)衛(wèi)生系統(tǒng)各種資源共享；政府和各級醫(yī)療機構(gòu)應(yīng)加大宣傳力度,讓老百姓能理解和支持這項改革措施；同時要加快信息化建設(shè),為區(qū)域醫(yī)療聯(lián)合提供信息保障等四個方面進行綜合考慮。
[Abstract]:The right to life and health is not because of race, age, gender, differences in economic level and social status of the high and low points, it is one of the most basic human rights, is the basis of human rights to any other. In order to ensure everyone can obtain the basic rights of life and health, countries are working in the construction of medical and health service system. At present, the medical and health undertakings along with our country economy to a substantial increase in the level of a larger development, but the level of medical technology has been improved significantly. However, due to various reasons, the current "disease difficult, expensive, tense doctor-patient relationship, city hospital doctor patient overcrowding, streams of people busily coming and going. The Central Committee of the Communist Party at the grassroots community hospital doctor who desolate phenomenon is still very serious.2009 year in April 6th the central government issued the State Council," on deepening the medical and health Reform opinions clearly pointed out: to improve the community health service of new city based medical and health service system, establish the cooperation between city hospital and community health institutions. From the policy level, the state gives the health system reform in the next goal, but also to establish a basic medical and health care system for people to enjoy the and gradually achieve the strategic goal of the basic medical and health services for all the direction. At the same time to establish a new city health service system, help to alleviate the troubled people see disease difficult, expensive medical social situation, the gap between urban and rural areas and narrow the gap between groups of members of society; is conducive to promoting regional economic development. To maintain social stability and harmony; more conducive to the early realization of the great "China dream" of the whole society.
However, in the process of constructing the new city health service system, how to promote city hospital and community health service institutions of the division of labor? A few medical institutions take what kind of cooperation? The Affiliated Hospital of Hangzhou Gongshu District City Health Bureau and Hangzhou Normal University set up a Medical Association, made a bold exploration for the establishment of the new city health service system. This paper describes the development level of domestic and International Medical Association, introduced the system of the establishment and development of Gongshu District Medical Association, as well as the problems existing in the process of development, and analyzes the causes of existing problems, puts forward corresponding solving methods.
This paper consists of five chapters. The first chapter is the introduction, put forward the topic and purpose, the main concepts, including public goods, basic medical and health services, and define the government leading medical association and its related concepts such as paper, put forward the main ideas and research methods and the possible innovations and deficiencies. The second chapter is the literature review, including the current situation in the domestic development of the Medical Association in the development of foreign and Commonwealth. Medical conjoined development in foreign countries, mainly introduced in the United States, Britain, Germany, Brazil and India and other countries in the development of the status quo; conjoined in domestic development, mainly introduced in Beijing, Shanghai, Hubei, the status quo Jiangsu, Zhenjiang and Henan and other places of development. The third chapter is the present development of Hangzhou Medical Association in Gongshu District City, the establishment of the Medical Association in Hangzhou, Gongshu District, the development of the status quo, development and operation For the existing problems. The fourth chapter is the analysis of the Medical Association in Hangzhou city Gongshu District cause development problems, analysis of reasons including internal lack of coordination, analysis of the problems of informatization construction, the problems existing in the two-way referral of patients in the analysis of the causes. The fifth chapter is the problems and put forward countermeasures and suggestions.
This paper argues that in order to build a new city health service system, the establishment of regional medical consortium, to be led by the government to co-ordinate the planning, establishment of cooperation mechanism of medical and health institutions at all levels; to establish the mechanism of balancing of interests, guiding the various resources sharing health system; the government and medical institutions at all levels should intensify propaganda, so that people can understand and support the reform measures; at the same time to speed up the construction of information technology for Regional Medical Association four aspects of information security such as a comprehensive consideration.

【學(xué)位授予單位】：安徽大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R197.1

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