Abstract: In order to deeply implement the measure of “two sinking and two improvement ”，some county medical health care units was established in 11 cities of Zhejiang Province in September 2017.After a series of work，a new community-centered health care model was constructed.County medical health care unit is a reconstruction of medical service system carried out by hospitals and primary health institutions through the integration of resources and joint management.It is a kind of reform and innovation faced with the dilemma of medical reform in today's society.After nearly two years' exploration，each unit has achieved certain effectiveness，unified all kinds of resources，reformed the“three medical linkage”，improved the level of medical services，and polished out its own bright spots in the light of their respective actual conditions.The county medical health care unit in Zhejiang Province has made remarkable achievements，but in the process of development，the positioning and division of labor among the members，the construction of the talent team of primary health institutions and the optimization of service level in the county medical health care unit have become problems that cannot be ignored.In this paper，the achievements made after the construction of the county medical health care unit in Zhejiang Province is described to provide the basis for the necessity of its construction，and existing problems are put forward to provide ideas for the development direction of the construction of the county medical health care unit.Only by introducing corresponding measures to solve the problems，the level of medical service can be improved.

Key words: Community health services, County medical health care unit, Primary care service, Progressive patient care

摘要： 浙江省在2017年9月为深入实施“双下沉、两提升”的举措，在11个市分别确定了1个县域医疗服务共同体建设试点，并开展了一系列的工作，形成了“基层首诊、分级诊疗、双向转诊”的良好就医格局。县域医疗服务共同体是上级医院与基层医疗卫生机构通过整合资源、实行共同管理而开展的一次医疗服务体系重构，是在当今社会面临医改困境所进行的一种改革创新。经过近两年的探索，各建设试点取得了一定的成效，统一各项资源，改革“三医联动”，提高医疗服务水平，还结合各自实际情况打磨出独属于自己的亮点。浙江省县域医疗服务共同体取得的成绩是瞩目的，但在发展进程中，县域医疗服务共同体内部成员的定位分工、基层卫生机构的人才队伍建设和服务水平的提高成了不可忽视的难题。本文阐述了浙江省医疗服务共同体建设开展后取得的成绩为医疗服务共同体建设的必要性提供依据，以及提出当前存在的问题为医疗服务共同体建设的发展方向提供思路，只有出台相应的举措来解决上述问题，医疗服务水平才能得到提高。

关键词: 社区卫生服务, 县域医疗服务共同体, 基层医疗服务, 患者分级医疗