Exploration and Practice of Primary Health Care during the Construction of County-level Medical Alliance

doi:10.12114/j.issn.1007-9572.2020.00.188

Abstract

Abstract: The construction of county-level medical alliance（CMA） is an important breakthrough to improve the ability of health care at grassroots level and deepen the medical reform. However，there is currently no unified operation mode of CMA in China. Zhejiang Province carried out the pilot construction of CMA in September 2017，and determined the pilot reform path of "three unifications" of unified institutional setting，staff recruitment and allocation，and medical and health resource allocation，"three integrated plans" for fiscal and financial management，medical insurance payment，and information sharing，and "three emphasis" on hierarchical diagnosis and treatment，contracted family doctor services，and public health. Zhejiang Province comprehensively promoted the above reform plan in the whole province in September 2018，and has made some positive progress. This paper summarizes and analyzes the main methods of health-related work in Zhejiang Province under the background of comprehensively promoting the construction of medical alliance. It mainly includes the work responsibilities and tasks of relevant departments，contracted services of family doctors，basic public health services，and the reform of compensation mechanism of primary health care institutions. In addition，this paper reports in detail the achievements that Zhejiang Province has made in terms of the grassroots service ability，CMA pattern，and the enthusiasm of primary health care staff since the construction of medical alliance. It is hoped that the practice of "Zhejiang Mode" in this paper can provide reference for the construction of medical alliance in other regions.

Key words: Medical alliance, County-level medical services, Primary health care, Practice, Effect, Health care reform

摘要： 县域医疗共同体（医共体）建设，是提升基层医疗卫生服务能力和深化医改的一个重要突破口，目前我国尚无统一运行模式。浙江省于2017年9月开展县域医共体建设试点，确定了医共体内机构设置、人员招聘使用、医疗卫生资源调配“三统一”，财政财务管理、医保支付、信息共享“三统筹”，分级诊疗、家庭医生签约服务、基本公共卫生服务“三强化”的改革试点路径，并于2018年9月全面推进，目前已取得积极进展。本文汇总分析了浙江省在全面推进医共体建设背景下开展基层卫生相关工作的主要做法，涉及相关方的工作职责和任务、家庭医生签约服务、基本公共卫生服务及基层医疗卫生机构补偿机制改革等。同时，本文对浙江省自开展医共体建设以来，在基层服务能力、县域医疗卫生服务格局及基层医务人员工作积极性方面取得的成效进行了较为详细汇报。希望本文针对“浙江模式”的实践探讨，能够为其他地区开展医共体建设提供参考与借鉴。

关键词: 医疗共同体, 县域医疗服务, 基层医疗卫生, 做法, 成效, 卫生保健改革

DAI Wenyun,HU Ling. Exploration and Practice of Primary Health Care during the Construction of County-level Medical Alliance　[J]. Chinese General Practice, 2021, 24(1): 23-29. DOI: 10.12114/j.issn.1007-9572.2020.00.188.
戴文芸,胡玲. 县域医疗共同体建设中做好基层医疗卫生工作的探索与实践[J]. 中国全科医学, 2021, 24(1): 23-29. DOI: 10.12114/j.issn.1007-9572.2020.00.188.

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