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	社区首诊双向转诊制度在中国为何难以实施; Why the “Community First Diagnosis and Two-way Referral” system is difficult to implement in China
	高和荣
	2014-03-15
英文摘要	起源于英国的社区首诊双向转诊制度为世界很多国家所效仿。本世纪初,中国政府发布发展城市社区卫生服务的指导意见,试点并逐步推广社区首诊双向转诊制度。通过对试点城市厦门的调研发现,厦门市社区首诊双向转诊制度以政府为主导重组医疗资源,把社区医院专有化为综合性三级医院一部分,让每家综合性三级医院托管部分社区医院,同时改革医疗保险制度,实行医保补贴等非市场化方式干预区域性医疗市场,引导民众首诊到社区医院。但是,社区医院的医护人员学历及职称普遍不高,科室及基本药品目录设置不合理,综合性三级医院的一些医生不愿来社区卫生服务中心坐诊,患者首选大医院的就医观念难以消除,双向转诊制度并没有很好地执行。这就要求我们应当加大全科医生的培养力度,完善基本药物制度,改善社区医院条件,落实社区首诊双向转诊制度,切实解决民众看病难看病贵问题。; The "Community First Diagnosis and Two-way Referral"(CFD-TR) system originated in the UK is imitated by many countries in the world.At the beginning of the century, Chinese government issued the guidelines for the health service in urban communities and tries to plot and spread it.Through the investigation in the pilot city of Xiamen, we found the system is dominated by the government to redistribute medical resources, the community hospitals are incorporated in the tertiary hospitals, which are comprehensive,and severalcommunityhospitals are commissioned to be managed by a tertiary hospital.At the same time, the medical insurance system is reformed, and the regional medical markets are intervened in such non-market ways as the medical insurance subsidies to attract people to take their first diagnoses in community hospitals.However, the educationalbackground and professionaltitlesof community hospital staff is generally not high,departments and the basic drug list have been set unreasonably, doctors in comprehensive tertiary hospitals are reluctant to serve in community hospital, which result in the stubbornness of patients' preference to the comprehensive hospital, the CFD-TR system is not implemented well.The current situation urges us to strengthen the efforts to train general medical practitioners, improve the "Basic Drug System" and the conditions of community hospital, and implement the CFD-TR system truly to easy the poor access and high fee of medical treatm ents.
语种	zh_CN
内容类型	期刊论文
源URL	[http://dspace.xmu.edu.cn/handle/2288/101915]
专题	公共事务－已发表论文
推荐引用方式 GB/T 7714	高和荣. 社区首诊双向转诊制度在中国为何难以实施, Why the “Community First Diagnosis and Two-way Referral” system is difficult to implement in China[J],2014.
APA	高和荣.(2014).社区首诊双向转诊制度在中国为何难以实施..
MLA	高和荣."社区首诊双向转诊制度在中国为何难以实施".(2014).

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