Abstract: Under the circumstance of hierarchical diagnosis and treatment,the functional orientation of primary medical and health institutions includes the following aspects:providing primary health care and basic public health services,of which primary health care is to provide first diagnosis,referral,continuity management services for patients with common diseases of clear and stable conditions,chronic diseases in stabilized phase,acute disease in rehabilitation,geriatric disease and advanced cancer.Currently the quantity and size of the financial aid of primary medical and health institutions in China are increasing continuously,but there are still problems such as lacking of policy guidance,insufficient capabilities of service,poor two-way referral channels,and lagging of information construction.From the perspective of achieving the goal of hierarchical diagnosis and treatment,the paper puts forward the following suggestions:establish effective policy guidance,play the platform function of primary medical and health institutions,establish incentive and restraint system,upper and lower linkage mechanism and integrate regional information systems.

Key words: Hierarchical diagnosis and treatment, Primary medical and health institutions, Current situation, Suggestions

摘要： 在分级诊疗下，基层医疗卫生机构的功能定位为：提供基本医疗和基本公共卫生服务，其中基本医疗是为诊断明确、病情稳定的常见病、慢性病稳定期、急性病康复期、老年病、晚期肿瘤患者提供首诊、转诊、连续性管理等服务。目前我国基层医疗卫生机构的数量和财政补助规模不断增加，但仍存在政策引导缺失、服务能力不足、双向转诊通道不畅、信息化建设滞后等问题。本文从实现分级诊疗目标的视角，提出基层医疗卫生机构发展的建议：建立有效的政策引导、发挥基层医疗卫生机构的平台功能、建立激励约束机制和上下联动机制及整合区域信息系统等。

关键词: 分级诊疗, 基层医疗卫生机构, 现状, 建议