上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (8): 919-.doi: 10.3969/j.issn.1674-8115.2010.08.012

• 论著（卫生事业管理） • 上一篇    下一篇

医卫联合体—中国式管理型医疗模式的有益探索

黄淇敏1, 黄登笑2, 郭莹莹1, 李亚芳3   

  1. 1.上海交通大学 |医学院第三人民医院卫生管理教研室, 上海 201900；2.上海交通大学 医学院第三人民医院医务部, 上海 201900；3.上海市青浦区朱家角人民医院, 上海 201713
  • 出版日期:2010-08-25 发布日期:2010-08-27
  • 作者简介:黄淇敏（1947—）, 男, 教授；电子信箱: qiminh@126.com。
  • 基金资助:

    上海市教委人文社科基金（07ZS45）

United medical group: positive exploration of Chinese managed health care model

HUANG Qi-min1, HUANG Deng-xiao2, GUO Ying-ying1, LI Ya-fang3   

  1. 1.Department of Health Management, 2.Department of Medical Administration, The Third People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 201900, China；3.Zhujiajiao People's Hospital of Qingpu District, Shanghai 201713, China
  • Online:2010-08-25 Published:2010-08-27
  • Supported by:

    Shanghai Education Committee Humanities and Social Sciences Foundation, 07ZS45

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摘要：

目的 探讨美国管理型医疗在中国的可借鉴之处与医卫联合体的发展前景，为促进区域性医卫联合体试点健康发展提出建议。方法 采用访谈、小型座谈法征询上海市有关政府部门和医疗机构15名专家对医疗改革的意见；采用随机抽样，选取实行医卫联合体的上海市A区及具有类似运行方式的B、C两区，共发放患者问卷560份（其中A区360份，B区100份，C区100份），医方问卷358份（其中A区258份，B区100份）。问卷内容包括医卫联合体的运行状况、效果、发展前景，管理型医疗保健的接受程度、发展前景等。结果 专家认可医卫联合体发展前景，但对模式运作提出质疑。调研回收医方问卷348份，有效问卷315份，回收患者问卷556份，有效问卷544份；认为管理型医疗保健部分理念可以借鉴的占被调查者72.38％，认为探索医卫联合体模式存在必要性的占53.33％；对模式知晓情况总体较差，66.94%认为其运作不佳，不同区首席医师制度运作上存在差异（P=0.000）；医患双方对于管理型医疗理念的接受程度存在显著差异（P<0.01）。结论 我国借鉴管理型医疗保健具有可行性，但应结合我国国情。医卫联合体是中国式管理型医疗模式的有益探索，具备健康发展前景，但宣传力度不足，运作状况不佳。推行新的政策应充分进行调研，探讨不同人群的接受程度。

关键词: 医卫联合体, 借鉴, 管理型医疗, 中国模式

Abstract:

Objective To explore the applicable experience of managed health care model as well as the prospect of united medical group model in China, and put forward suggestions for promoting the healthy development of united medical group. Methods Interviews and small-scale group meetings were conducted to seek the opinions on medical reform from 15 experts of relevant governmental departments and medical institutions in Shanghai. District A undergoing united medical group model and District B and District C with similar model of operation in Shanghai were chosen, and 560 patients (360 in District A, 100 in District B and 100 in District C) and 358 medical staff (258 in District A and 100 in District B) were randomly selected for questionnaire interviews, which were concerned with the operation, results and prospect of united medical group model as well as the feasibility and prospect of managed health care model. Results Favourable prospect of united medical group model was concluded by experts with suspected way of operation. A total of 348 and 556 questionnaires were recovered from medical staff and patients, respectively, with 315 and 544 effective questionnaires, respectively. 72.38% of the respondents held the opinion that managed health care model could be partially applied to united medical group model, and 53.33% believed it was necessary to try the united medical group model. The awareness of models was not ideal among the respondents, unfavourable operation was considered by 66.94%, and there were significant differences in the management of primary care physician system between District A and District B (P=0.000). There were significant differences in the acceptance level of managed health care model between medical staff and patients (P<0.01). Conclusion It is feasible for China to learn from managed health care model under national conditions. Though lack of publicity with poor operation now, united medical group model is a positive exploration of Chinese managed health care model, and may have a sound future.

Key words: united medical group, learning, managed health care, Chinese model