本文選題：分級(jí)診療　切入點(diǎn)：醫(yī)聯(lián)體　出處：《西南交通大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：隨著新醫(yī)改的實(shí)施,醫(yī)療保險(xiǎn)實(shí)現(xiàn)了全面覆蓋,人民群眾的醫(yī)療衛(wèi)生需求被大量釋放。各類醫(yī)療衛(wèi)生機(jī)構(gòu)迅速發(fā)展,民營(yíng)醫(yī)院數(shù)量顯著增加,病員和醫(yī)生更多地聚向了城市大醫(yī)院,但鄉(xiāng)鎮(zhèn)衛(wèi)生院卻出現(xiàn)了萎縮的跡象,其機(jī)構(gòu)數(shù)量、服務(wù)數(shù)量和服務(wù)占比不增反降,這違背了醫(yī)療改革的初衷。在大型醫(yī)院依然存在著"看病難、看病貴"問題的同時(shí),鄉(xiāng)鎮(zhèn)衛(wèi)生院的人力和設(shè)備卻閑置浪費(fèi)。2015年,國(guó)家全面推行分級(jí)診療制度,希望通過"基層首診、雙向轉(zhuǎn)診、急慢分治和上下聯(lián)動(dòng)"等措施將醫(yī)療資源向基層引導(dǎo),旨在建立合理的就診秩序。國(guó)家將采取一系列醫(yī)療、醫(yī)保、人事等政策將患者、醫(yī)務(wù)人員、診療行為留在縣域范圍內(nèi)的基層醫(yī)療機(jī)構(gòu)。對(duì)于鄉(xiāng)鎮(zhèn)衛(wèi)生院來說,這既是前所未有過的發(fā)展機(jī)會(huì),但也面臨著嚴(yán)峻的挑戰(zhàn)。在此輪醫(yī)療衛(wèi)生資源下沉過程中,鄉(xiāng)鎮(zhèn)衛(wèi)生院若未能順勢(shì)提高市場(chǎng)占有率,具有比較優(yōu)勢(shì)的縣級(jí)醫(yī)療機(jī)構(gòu)將因獲得更多的下沉資源而更具競(jìng)爭(zhēng)力,屆時(shí)鄉(xiāng)鎮(zhèn)衛(wèi)生院的生存和發(fā)展將比當(dāng)前更加困難。面對(duì)機(jī)會(huì)與挑戰(zhàn)并存的外部環(huán)境,鄉(xiāng)鎮(zhèn)衛(wèi)生院必須要預(yù)判未來趨勢(shì),找準(zhǔn)定位,制定合理的規(guī)劃,主動(dòng)適應(yīng)這種變革,努力抓住機(jī)會(huì),避開挑戰(zhàn),方能平穩(wěn)度過艱難的變革期并謀求長(zhǎng)遠(yuǎn)的發(fā)展。本文以X鎮(zhèn)衛(wèi)生院為對(duì)象,對(duì)內(nèi)外部環(huán)境進(jìn)行了全面梳理和分析探討。首先通過PEST分析法對(duì)政治、經(jīng)濟(jì)、社會(huì)、文化以及科技等宏觀環(huán)境進(jìn)行了分析,并針對(duì)當(dāng)前倍受重視的"生態(tài)文明建設(shè)"對(duì)醫(yī)療機(jī)構(gòu)的影響進(jìn)行了創(chuàng)新性探索,運(yùn)用波特"五力"分析模型對(duì)行業(yè)競(jìng)爭(zhēng)格局進(jìn)行了研究,同時(shí)還針對(duì)當(dāng)前分級(jí)診療模式下醫(yī)療機(jī)構(gòu)間的競(jìng)爭(zhēng)合作關(guān)系進(jìn)行了創(chuàng)新性探討,最后對(duì)X鎮(zhèn)衛(wèi)生院內(nèi)部財(cái)務(wù)狀況、服務(wù)能力、服務(wù)效率、營(yíng)銷能力和組織效率進(jìn)行了綜合性分析。通過梳理總結(jié)出了該機(jī)構(gòu)所面臨的10項(xiàng)機(jī)會(huì)和8項(xiàng)威脅,以及其所具備的6項(xiàng)優(yōu)勢(shì)和9項(xiàng)劣勢(shì)。根據(jù)SWOT分析和分級(jí)診療制度等國(guó)家政策為該機(jī)構(gòu)理清了使命、宗旨和目標(biāo),通過SWOT態(tài)勢(shì)分析法就X鎮(zhèn)衛(wèi)生院應(yīng)該如何運(yùn)用自身的優(yōu)勢(shì)去抓住外部機(jī)會(huì),又該怎樣改善自身的劣勢(shì)避免威脅等問題做出了創(chuàng)新發(fā)展的戰(zhàn)略選擇,并制定了具體的戰(zhàn)略實(shí)施方案和實(shí)施過程中的控制預(yù)案。最后,對(duì)該機(jī)構(gòu)戰(zhàn)略實(shí)施效果進(jìn)行了階段性評(píng)估,進(jìn)一步認(rèn)為在戰(zhàn)略實(shí)施初期,管理者應(yīng)重點(diǎn)關(guān)注并督導(dǎo)戰(zhàn)略方案的執(zhí)行,以確保戰(zhàn)略目標(biāo)的最終實(shí)現(xiàn)。
[Abstract]:With the implementation of the new medical reform, medical insurance has been fully covered, and the mass medical and health needs of the people have been released in large quantities. Various kinds of medical and health institutions have developed rapidly, and the number of private hospitals has increased significantly. More patients and doctors have gathered to major urban hospitals, but township hospitals have shown signs of shrinking, with the number of institutions, the number of services and the proportion of services falling rather than increasing. This goes against the original intention of health care reform. While the problem of "difficult and expensive to see a doctor" still exists in large hospitals, the manpower and equipment of township health centers are idle and wasted. In 2015, the state comprehensively implemented the hierarchical diagnosis and treatment system. It is hoped that medical resources will be directed to the grass-roots level through such measures as "first diagnosis at the grass-roots level, two-way referral, acute and slow separation and linkage between the upper and lower levels." the aim is to establish a reasonable medical order. The state will adopt a series of policies such as medical care, medical insurance, personnel and other policies to bring patients to the primary level. Medical personnel, the primary medical institutions whose diagnosis and treatment behavior remains within the county scope. For township health centers, this is not only an unprecedented opportunity for development, but also a serious challenge. In the course of this round of medical and health resources sinking, If township health centers fail to increase their market share, county-level medical institutions with comparative advantages will be more competitive because they have more sinking resources. At that time, the survival and development of township health centers will be more difficult than at present. In the face of the external environment where opportunities and challenges coexist, township health centers must anticipate future trends, find a correct orientation, formulate reasonable plans, and actively adapt to this kind of change. Only by seizing the opportunity and avoiding the challenge, can we smoothly pass the difficult period of change and seek long-term development. This paper, taking the X Township Health Center as the object, comprehensively combs and analyzes the internal and external environment. Firstly, through the PEST analysis method, we analyze the politics, The macro environment, such as economy, society, culture and science and technology, is analyzed, and the influence of "ecological civilization construction", which has been paid more attention to, on medical institutions has been explored innovatively. Using Porter's "five forces" analysis model to study the competition pattern of the industry, at the same time, aiming at the innovative relationship of competition and cooperation among medical institutions under the current classified diagnosis and treatment mode, finally, the financial situation of X Township Health Center is discussed. Comprehensive analysis of service capability, service efficiency, marketing capability and organizational efficiency. By sorting out 10 opportunities and 8 threats to the organization, As well as its 6 strengths and 9 disadvantages. According to the national policies such as SWOT analysis and hierarchical diagnosis and treatment system, it clarifies the mission, purpose and goal of the organization. Through the analysis of SWOT situation, the paper makes a strategic choice of how to make use of its own advantages to seize external opportunities and how to improve its inferiority to avoid threats, and so on. Finally, the paper evaluates the effect of the strategy implementation in stages, and further thinks that in the early stage of the strategy implementation, Managers should focus on and oversee the implementation of strategic programs to ensure the ultimate achievement of strategic objectives.
【學(xué)位授予單位】：西南交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R197.62

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