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北京市正在推行的企业职工大病统筹方案,给基层医院带来了冲击和挑战,同时也带来了机遇。通过讨论医疗保障制度改革的必要性、迫切性,分析了北京市医疗机构的工作现状。由于医院间的竞争,大医院和基层医院的工作量变化呈不同趋势,而基层医院的医疗费用明显低于大医院,三级医疗卫生网面临解体的威胁。在这个基础上,新推出的企业职工大病医疗统筹工作给基层医院带来了严重的冲击:由于实行定点医疗制度,病人流向大医院,分层次医疗和转诊缺乏必要的行政干预手段,造成医疗卫生资源的不足和浪费并存。为此,我认为基层医院应主动适应医疗保障体制的改革,通过政府干预实施医疗规划,发挥自己医疗费用低、就医方便等方面的优势,增强竞争实力,明确基层医院在医疗保障体制改革中的地位,加强预防保健的力度,密切与社区的联系,扩大医院的功能。
The plan for co-ordinating major employee illnesses in Beijing is bringing shocks and challenges to grass-roots hospitals as well as opportunities. By discussing the necessity and urgency of the reform of the medical security system, the status quo of the medical institutions in Beijing is analyzed. Due to the competition among hospitals, the workload of major hospitals and grass-roots hospitals has changed in different directions, while the medical costs of primary hospitals are significantly lower than those of large hospitals, and the tertiary healthcare network is threatened with disintegration. On this basis, the newly-launched medical staff work plan for major illnesses has brought serious impacts on grass-roots hospitals: due to the implementation of fixed-point medical systems, patients have flown to large hospitals, and hierarchical medical treatment and referral lack the necessary administrative intervention to cause medical problems. The shortage and waste of health resources coexist. For this reason, I believe that grass-roots hospitals should actively adapt to the reform of the medical security system, implement medical plans through government intervention, give full play to their advantages in low medical costs and convenient medical treatment, strengthen their competitive strength, and clarify the basic level hospitals in the reform of the medical security system. Status, strengthening prevention of health care, close contact with the community, and expanding the function of the hospital.