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国务院办公厅关于推进医联体建设和发展的指导意见

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发表于 2020-10-19 23:23:56 | 显示全部楼层 |阅读模式

                    

                    

                    
                    
                    <p><br  /></p><p><img data-type="gif" src="http://mmbiz.qpic.cn/mmbiz_gif/dx3KibwtDhvezhWjA9OE2EwumicC4kMAsKk2Pz01VsicM98wnG2rBnzvRXWGQfIaBFWuvAEFj8pu4K9TnhxowfPGw/0?wx_fmt=gif" data-ratio="0.1703125" data-w="640"  /><br  /></p><p><br  /></p><p><span style="font-size: 18px; color: rgb(0, 122, 170);">4月26日,国务院办公厅印发《关于推进医疗联合体建设和发展的指导意见》(以下简称《意见》),全面启动多种形式的医疗联合体建设试点。</span></p><p><span style="font-size: 18px; color: rgb(0, 122, 170);"><br  /></span></p><p><span style="font-size: 18px; color: rgb(0, 122, 170);"><span style="color: rgb(0, 122, 170); font-size: 16px;"></span></span></p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-family: 微软雅黑; font-size: 16px; white-space: normal; text-align: justify; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);">《意见》指出,建设和发展医联体,是贯彻以人民为中心的发展思想、落实《政府工作报告》部署的重点任务,是深化医疗医保医药联动改革、合理配置资源、使基层群众享受优质便利医疗服务的重要举措,有利于调整优化医疗资源结构布局,促进医疗卫生工作重心下移和资源下沉,提升基层服务能力;有利于医疗资源上下贯通,提升医疗服务体系整体效能,更好实施分级诊疗和满足群众健康需求。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-family: 微软雅黑; font-size: 16px; white-space: normal; text-align: justify; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);">《意见》提出,医联体建设与发展要立足我国经济社会和医药卫生事业发展实际,以落实医疗机构功能定位、提升基层服务能力、理顺双向转诊流程为重点,按照政府主导、统筹规划,坚持公益、创新机制,资源下沉、提升能力,便民惠民、群众受益等原则加以推进。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-family: 微软雅黑; font-size: 16px; text-indent: 0em; white-space: normal; text-align: justify; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);">2017年,全面启动多种形式的医联体建设试点,三级公立医院要全部参与并发挥引领作用,综合医改试点省份每个地市以及分级诊疗试点城市至少建成一个有明显成效的医联体。到2020年,在总结试点经验的基础上,全面推进医联体建设,形成较为完善的医联体政策体系。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-family: 微软雅黑; font-size: 16px; white-space: normal; text-align: justify; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);">《意见》提出,要根据本地区分级诊疗制度建设实际情况,因地制宜、分类指导,逐步形成多种形式的医联体组织模式。在城市主要组建医疗集团,在县域主要组建医疗共同体,跨区域组建专科联盟,在医疗资源不足的边远贫困地区大力发展远程医疗协作网。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-family: 微软雅黑; font-size: 16px; white-space: normal; text-align: justify; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);">《意见》要求,要完善医联体内部分工协作机制。建立组织管理和协作制度,落实医疗机构功能定位,以需求为导向做实家庭医生签约服务,完善医联体内双向转诊机制。同时,要促进医联体内部优质医疗资源上下贯通,统筹人员调配、薪酬分配、资源共享等,促进人力资源有序流动,实现诊疗信息互联互通。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-family: 微软雅黑; font-size: 16px; white-space: normal; text-align: justify; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);">《意见》强调,要完善各项保障政策。进一步落实政府办医主体责任,探索对纵向合作的医联体等分工协作模式实行医保总额付费等多种付费方式,完善人员保障和激励机制,建立与医联体相适应的绩效考核机制。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-family: 微软雅黑; font-size: 16px; white-space: normal; text-align: justify; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><br  /></p><p><span style="font-size: 18px; color: rgb(0, 122, 170);"><span style="color: rgb(0, 122, 170); font-size: 16px;"></span></span></p><section data-role="outer" label="Powered by gulangu" style="max-width: 100%; color: rgb(62, 62, 62); font-size: 16px; line-height: 25.6px; white-space: normal; font-family: 微软雅黑; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><section class="" data-tools="gulangu" data-id="88399" data-color="rgb(30, 155, 232)" data-custom="rgb(30, 155, 232)" style="max-width: 100%; box-sizing: border-box; border: 0px none; word-wrap: break-word !important;"><section style="margin-top: 40px; margin-bottom: 10px; max-width: 100%; text-align: center; transform: translate3d(0px, 0px, 0px); box-sizing: border-box !important; word-wrap: break-word !important;"><section data-width="100%" style="padding: 10px; max-width: 100%; box-sizing: border-box; display: inline-block; width: 590px; border: 1px solid rgb(30, 155, 232); box-shadow: rgb(204, 204, 204) 3.53553px 3.53553px 4px 0px; word-wrap: break-word !important;"><section style="margin-top: 10px; max-width: 100%; text-align: left; box-sizing: border-box !important; word-wrap: break-word !important;"><section class="" style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 0, 0); box-sizing: border-box !important; word-wrap: break-word !important;"> </span> (一)指导思想。全面贯彻党的十八大和十八届三中、四中、五中、六中全会以及全国卫生与健康大会精神,认真落实党中央、国务院决策部署,统筹推进“五位一体”总体布局和协调推进“四个全面”战略布局,牢固树立和贯彻落实创新、协调、绿色、开放、共享的发展理念,坚持以人民为中心的发展思想,立足我国经济社会和医药卫生事业发展实际,以落实医疗机构功能定位、提升基层服务能力、理顺双向转诊流程为重点,不断完善医联体组织管理模式、运行机制和激励机制,逐步建立完善不同级别、不同类别医疗机构间目标明确、权责清晰、公平有效的分工协作机制,推动构建分级诊疗制度,实现发展方式由以治病为中心向以健康为中心转变。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  (二)基本原则。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  政府主导,统筹规划。落实政府规划、指导、协调、监管、宣传等职能,以城市和县域为重点,根据区域医疗资源结构布局和群众健康需求,按照业务相关、优势互补、双向选择、持续发展等要求,兼顾既往形成的合作关系,统筹安排医疗机构组建医联体。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  坚持公益,创新机制。坚持政府办医主体责任不变,切实维护和保障基本医疗卫生事业的公益性。坚持医疗、医保、医药联动改革,创新机制,逐步破除行政区划、财政投入、医保支付、人事管理等方面的壁垒和障碍,优化资源结构布局,结合医保支付方式等改革的推进,逐步建立完善医疗机构间分工协作机制。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  资源下沉,提升能力。利用三级公立医院优质资源集中的优势,通过技术帮扶、人才培养等手段,发挥对基层的技术辐射和带动作用。鼓励医联体内统一管理模式,发挥集约优势,推进区域医疗资源共享,发挥科技引领与支撑作用,提高医疗服务体系整体能力与绩效。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  便民惠民,群众受益。坚持以人民健康为中心,逐步实现医疗质量同质化管理,强化基层医疗卫生机构的居民健康“守门人”能力,推进慢性病预防、治疗、管理相结合,促进医联体建设与预防、保健相衔接,方便群众就近就医,减轻疾病负担,防止因病致贫返贫,促进健康产业发展和经济转型升级,增强群众获得感。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  (三)工作目标。2017年,基本搭建医联体制度框架,全面启动多种形式的医联体建设试点,三级公立医院要全部参与并发挥引领作用,综合医改试点省份每个地市以及分级诊疗试点城市至少建成一个有明显成效的医联体。探索对纵向合作的医联体等分工协作模式实行医保总额付费等多种方式,引导医联体内部初步形成较为科学的分工协作机制和较为顺畅的转诊机制。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  到2020年,在总结试点经验的基础上,全面推进医联体建设,形成较为完善的医联体政策体系。所有二级公立医院和政府办基层医疗卫生机构全部参与医联体。不同级别、不同类别医疗机构间建立目标明确、权责清晰、公平有效的分工协作机制,建立责权一致的引导机制,使医联体成为服务、责任、利益、管理共同体,区域内医疗资源有效共享,基层服务能力进一步提升,有力推动形成基层首诊、双向转诊、急慢分治、上下联动的分级诊疗模式。</p><section class="" data-tools="gulangu" data-id="89536" style="max-width: 100%; box-sizing: border-box; border: 0px none; word-wrap: break-word !important;"><section style="margin-right: auto; margin-left: auto; max-width: 100%; box-sizing: border-box; border: 0px; word-wrap: break-word !important;"><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; width: 42px; height: 50px; vertical-align: top; line-height: 50px; text-align: center; color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWuIkiaMRfF2nPrvryogjrO4XfhpWegMwicuiapXBQia8qeINYhefTtwGfrQ/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"><p style="max-width: 100%; min-height: 1em; font-size: 20px; border: 0px; box-sizing: border-box !important; word-wrap: break-word !important;">0<span class="" data-original-title="" title="" style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">2</span></p></section><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; height: 50px; box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWEnrBa7fuiccJgxAndh66NF0fKuTFduWXp2icIoXhBpibVePONwaJ3Jvzg/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"><section style="padding-left: 10px; max-width: 100%; box-sizing: border-box; display: inline-block; line-height: 50px; color: rgb(51, 51, 51); vertical-align: top; word-wrap: break-word !important;"><p class="" data-brushtype="text" style="max-width: 100%; min-height: 1em; font-size: 14px; border: 0px; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">逐步形成多种形式的医联体组织模式</strong></span></p></section></section><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; width: 17px; height: 50px; vertical-align: top; box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWzfenALo6kEeDUGXCyFibSibU24BtebdP2ialR438RwuG8TnZUIv9k8Ubg/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"></section></section></section><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 0, 0); box-sizing: border-box !important; word-wrap: break-word !important;">  </span>各地要根据本地区分级诊疗制度建设实际情况,因地制宜、分类指导,充分考虑医疗机构地域分布、功能定位、服务能力、业务关系、合作意愿等因素,充分发挥中央、地方、军队、社会各类医疗资源作用,尊重基层首创精神,探索分区域、分层次组建多种形式的医联体,推动优质医疗资源向基层和边远贫困地区流动。根据社会办医疗机构意愿,可将其纳入医联体。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  (一)在城市主要组建医疗集团。在设区的市级以上城市,由三级公立医院或者业务能力较强的医院牵头,联合社区卫生服务机构、护理院、专业康复机构等,形成资源共享、分工协作的管理模式。在医联体内以人才共享、技术支持、检查互认、处方流动、服务衔接等为纽带进行合作。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  (二)在县域主要组建医疗共同体。重点探索以县级医院为龙头、乡镇卫生院为枢纽、村卫生室为基础的县乡一体化管理,与乡村一体化管理有效衔接。充分发挥县级医院的城乡纽带作用和县域龙头作用,形成县乡村三级医疗卫生机构分工协作机制,构建三级联动的县域医疗服务体系。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  (三)跨区域组建专科联盟。根据不同区域医疗机构优势专科资源,以若干所医疗机构特色专科技术力量为支撑,充分发挥国家医学中心、国家临床医学研究中心及其协同网络的作用,以专科协作为纽带,组建区域间若干特色专科联盟,形成补位发展模式,重点提升重大疾病救治能力。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  (四)在边远贫困地区发展远程医疗协作网。大力发展面向基层、边远和欠发达地区的远程医疗协作网,鼓励公立医院向基层医疗卫生机构提供远程医疗、远程教学、远程培训等服务,利用信息化手段促进资源纵向流动,提高优质医疗资源可及性和医疗服务整体效率。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  城市与农村之间可以城市三级公立医院为主体单位,在已建立的长期稳定对口支援关系基础上,通过托管区域内县级医院等多种形式组建医联体,三级公立医院可向县级医院派驻管理团队和专家团队,重点帮扶提升县级医院医疗服务能力与水平。国家级和省级公立医院除参加属地医联体外,可跨区域与若干医联体建立合作关系,组建高层次、优势互补的医联体,开展创新型协同研究、技术普及推广和人才培养,辐射带动区域医疗服务能力提升。</p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><section class="" data-tools="gulangu" data-id="89536" style="max-width: 100%; box-sizing: border-box; border: 0px none; word-wrap: break-word !important;"><section style="margin-right: auto; margin-left: auto; max-width: 100%; box-sizing: border-box; border: 0px; word-wrap: break-word !important;"><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; width: 42px; height: 50px; vertical-align: top; line-height: 50px; text-align: center; color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWuIkiaMRfF2nPrvryogjrO4XfhpWegMwicuiapXBQia8qeINYhefTtwGfrQ/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"><p style="max-width: 100%; min-height: 1em; font-size: 20px; border: 0px; box-sizing: border-box !important; word-wrap: break-word !important;">0<span class="" data-original-title="" title="" style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">3</span></p></section><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; height: 50px; box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWEnrBa7fuiccJgxAndh66NF0fKuTFduWXp2icIoXhBpibVePONwaJ3Jvzg/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"><section style="padding-left: 10px; max-width: 100%; box-sizing: border-box; display: inline-block; line-height: 50px; color: rgb(51, 51, 51); vertical-align: top; word-wrap: break-word !important;"><p class="" data-brushtype="text" style="max-width: 100%; min-height: 1em; font-size: 14px; border: 0px; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">完善医联体内部分工协作机制</span></strong></p></section></section><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; width: 17px; height: 50px; vertical-align: top; box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWzfenALo6kEeDUGXCyFibSibU24BtebdP2ialR438RwuG8TnZUIv9k8Ubg/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"></section></section></section><p style="max-width: 100%; min-height: 1em; color: rgb(160, 160, 160); font-size: 11.76px; text-align: justify; line-height: 25.6px; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 0, 0); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;"> </span></p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; text-indent: 2em; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(一)完善组织管理和协作制度。</strong>制定医联体章程,规定主体单位与其他成员单位的责任、权利和义务,完善医疗质量管理等制度,提高管理效率。医联体可探索在医院层面成立理事会。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(二)落实医疗机构功能定位。</strong>医联体建立责任共担和利益分配机制,调动医联体内各医疗机构积极性,落实功能定位。三级医院逐步减少常见病、多发病、病情稳定的慢性病患者比例。基层医疗卫生机构和专业康复机构、护理院等为诊断明确、病情稳定的慢性病患者、康复期患者、老年病患者、晚期肿瘤患者等提供治疗、康复、护理服务。鼓励村卫生室根据当地群众就医需求,加强公共卫生和健康管理服务,做好疾病预防控制工作。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;"> <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"> (三)扎实推进家庭医生签约服务。</strong>加强全科医生培养。以高血压、糖尿病等慢性病为重点,在医联体内加快推进家庭医生签约服务,优先覆盖老年人、孕产妇、儿童、残疾人等重点人群,以需求为导向做实家庭医生签约服务,2017年要把所有贫困人口纳入签约服务范围。通过签约服务,鼓励和引导居民在医联体内到基层首诊,上级医院对签约患者提供优先接诊、优先检查、优先住院等服务。探索对部分慢性病签约患者提供不超过2个月用药量的长处方服务,有条件的地方可以根据双向转诊患者就医需求,通过延伸处方、集中配送等形式加强基层和上级医院用药衔接,方便患者就近就医取药。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(四)为患者提供连续性诊疗服务。</strong>鼓励护理院、专业康复机构等加入医联体。建立医联体内转诊机制,重点畅通向下转诊通道,将急性病恢复期患者、术后恢复期患者及危重症稳定期患者及时转诊至下级医疗机构继续治疗和康复,加强医疗卫生与养老服务相结合,为患者提供一体化、便利化的疾病诊疗—康复—长期护理连续性服务。</p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><section class="" data-tools="gulangu" data-id="89536" style="max-width: 100%; box-sizing: border-box; border: 0px none; word-wrap: break-word !important;"><section style="margin-right: auto; margin-left: auto; max-width: 100%; box-sizing: border-box; border: 0px; word-wrap: break-word !important;"><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; width: 42px; height: 50px; vertical-align: top; line-height: 50px; text-align: center; color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWuIkiaMRfF2nPrvryogjrO4XfhpWegMwicuiapXBQia8qeINYhefTtwGfrQ/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"><p style="max-width: 100%; min-height: 1em; font-size: 20px; border: 0px; box-sizing: border-box !important; word-wrap: break-word !important;">0<span class="" data-original-title="" title="" style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">4</span></p></section><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; height: 50px; box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWEnrBa7fuiccJgxAndh66NF0fKuTFduWXp2icIoXhBpibVePONwaJ3Jvzg/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"><section style="padding-left: 10px; max-width: 100%; box-sizing: border-box; display: inline-block; line-height: 50px; color: rgb(51, 51, 51); vertical-align: top; word-wrap: break-word !important;"><p class="" data-brushtype="text" style="max-width: 100%; min-height: 1em; font-size: 14px; border: 0px; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">促进医联体内部优质医疗资源上下贯通</strong></span></p></section></section><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; width: 17px; height: 50px; vertical-align: top; box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWzfenALo6kEeDUGXCyFibSibU24BtebdP2ialR438RwuG8TnZUIv9k8Ubg/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"></section></section></section><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; text-indent: 2em; box-sizing: border-box !important; word-wrap: break-word !important;">鼓励医联体内医疗机构在保持行政隶属关系和财政投入渠道不变的前提下,统筹人员调配、薪酬分配、资源共享等,形成优质医疗资源上下贯通的渠道和机制。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(一)促进人力资源有序流动。</strong>统一调配医技等资源,发挥现有资源的最大使用效率。医联体内统筹薪酬分配,充分调动医务人员积极性。鼓励医联体内二级以上医疗机构向基层医疗卫生机构派出专业技术和管理人才。在医联体(包括跨区域医联体)内,医务人员在签订帮扶或者托管协议的医疗机构内执业,不需办理执业地点变更和执业机构备案手续。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(二)提升基层医疗服务能力。</strong>充分发挥三级公立医院牵头引领作用,针对区域内疾病谱和重点疾病诊疗需求,派出医务人员通过专科共建、临床带教、业务指导、教学查房、科研和项目协作等多种方式,促进优质医疗资源共享和下沉基层。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;"> <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"> (三)统一信息平台。</strong>加强规划设计,充分发挥信息系统对医联体的支撑作用,结合建立省、市、县三级人口健康信息平台,统筹推进医联体相关医院管理、医疗服务等信息平台建设,实现电子健康档案和电子病历的连续记录和信息共享,实现医联体内诊疗信息互联互通。医联体可以共享区域内居民健康信息数据,便捷开展预约诊疗、双向转诊、健康管理、远程医疗等服务,方便患者看病就医,提高医学科研技术水平。发挥远程医疗作用,促进医疗资源贴近城乡基层,探索实行远程医疗收费和支付政策,促进远程医疗服务可持续发展。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(四)实现区域资源共享。</strong>医联体内可建立医学影像中心、检查检验中心、消毒供应中心、后勤服务中心等,为医联体内各医疗机构提供一体化服务。在加强医疗质量控制的基础上,医联体内医疗机构间互认检查检验结果。探索建立医联体内统一的药品招标采购、管理平台,形成医联体内处方流动、药品共享与配送机制。</p><section class="" data-tools="gulangu" data-id="89536" style="max-width: 100%; box-sizing: border-box; border: 0px none; word-wrap: break-word !important;"><section style="margin-right: auto; margin-left: auto; max-width: 100%; box-sizing: border-box; border: 0px; word-wrap: break-word !important;"><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; width: 42px; height: 50px; vertical-align: top; line-height: 50px; text-align: center; color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWuIkiaMRfF2nPrvryogjrO4XfhpWegMwicuiapXBQia8qeINYhefTtwGfrQ/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"><p style="max-width: 100%; min-height: 1em; font-size: 20px; border: 0px; box-sizing: border-box !important; word-wrap: break-word !important;">0<span class="" data-original-title="" title="" style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">5</span></p></section><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; height: 50px; box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWEnrBa7fuiccJgxAndh66NF0fKuTFduWXp2icIoXhBpibVePONwaJ3Jvzg/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"><section style="padding-left: 10px; max-width: 100%; box-sizing: border-box; display: inline-block; line-height: 50px; color: rgb(51, 51, 51); vertical-align: top; word-wrap: break-word !important;"><p class="" data-brushtype="text" style="max-width: 100%; min-height: 1em; font-size: 14px; border: 0px; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">保障政策</span></strong></p></section></section><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; width: 17px; height: 50px; vertical-align: top; box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWzfenALo6kEeDUGXCyFibSibU24BtebdP2ialR438RwuG8TnZUIv9k8Ubg/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"></section></section></section><p style="max-width: 100%; min-height: 1em; color: rgb(160, 160, 160); font-size: 11.76px; text-align: justify; line-height: 25.6px; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 0, 0); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">  </span></strong></p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; text-indent: 2em; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(一)进一步落实政府办医主体责任。</strong>加大中央基建投资支持力度,加快补齐医联体发展短板,提高区域内疑难重病诊疗能力、县级医院综合能力以及远程医疗协作水平,推动医联体更好在基层发挥作用。地方各级人民政府要落实办医主体责任,落实公立医院投入政策,建立财政补助资金与绩效评价结果挂钩机制。医联体内各医疗机构的产权归属保持不变,继续按照原渠道拨付财政补助经费。鼓励医联体通过技术支援、人才培养等方式,吸引社会办医疗机构加入并发挥作用。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(二)进一步发挥医保经济杠杆作用。</strong>发挥医保对医疗服务供需双方的引导作用。合理拉开基层医疗卫生机构、县级医院和城市大医院间报销水平差距,增强在基层看病就医的吸引力,引导参保患者有序就诊。探索对纵向合作的医联体等分工协作模式实行医保总额付费等多种付费方式,并制定相应的考核办法,引导医联体内部形成顺畅的转诊机制,促使优质医疗资源下沉。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(三)完善人员保障和激励机制。</strong>按照“允许医疗卫生机构突破现行事业单位工资调控水平,允许医疗服务收入扣除成本并按规定提取各项基金后主要用于人员奖励”的要求,完善与医联体相适应的绩效工资政策,健全与岗位职责、工作业绩、实际贡献紧密联系的分配激励机制。落实医院用人自主权,实行按需设岗、按岗聘用,建立能上能下、能进能出的灵活用人机制。创新人事管理制度,完善与医联体相适应的职称晋升办法,实行科学评价,拓展医务人员职业发展空间。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(四)建立与医联体相适应的绩效考核机制。</strong>强化考核和制度约束,建立医联体考核指标体系,重点考核医联体技术辐射带动情况、医疗资源下沉情况等,不单纯考核业务量,要将三级医院医疗资源下沉情况、与基层医疗卫生机构协作情况以及基层诊疗量占比、双向转诊比例、居民健康改善等指标纳入考核体系,引导三级医院履行责任、完善措施,主动帮扶基层,切实发挥引领作用,引导各级各类医疗机构积极参与。将考核评价结果作为人事任免、评优评先等的重要依据,并与医务人员绩效工资、进修、晋升等挂钩。</p><section class="" data-tools="gulangu" data-id="89536" style="max-width: 100%; box-sizing: border-box; border: 0px none; word-wrap: break-word !important;"><section style="margin-right: auto; margin-left: auto; max-width: 100%; box-sizing: border-box; border: 0px; word-wrap: break-word !important;"><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; width: 42px; height: 50px; vertical-align: top; line-height: 50px; text-align: center; color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWuIkiaMRfF2nPrvryogjrO4XfhpWegMwicuiapXBQia8qeINYhefTtwGfrQ/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"><p style="max-width: 100%; min-height: 1em; font-size: 20px; border: 0px; box-sizing: border-box !important; word-wrap: break-word !important;">0<span class="" data-original-title="" title="" style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">6</span></p></section><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; height: 50px; box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWEnrBa7fuiccJgxAndh66NF0fKuTFduWXp2icIoXhBpibVePONwaJ3Jvzg/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"><section style="padding-left: 10px; max-width: 100%; box-sizing: border-box; display: inline-block; line-height: 50px; color: rgb(51, 51, 51); vertical-align: top; word-wrap: break-word !important;"><p class="" data-brushtype="text" style="max-width: 100%; min-height: 1em; font-size: 14px; border: 0px; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">组织实施</strong></span></p></section></section><section style="margin-right: auto; margin-left: auto; max-width: 100%; display: inline-block; width: 17px; height: 50px; vertical-align: top; box-sizing: border-box !important; word-wrap: break-word !important; background-image: url(&quot;http://mmbiz.qpic.cn/mmbiz_png/ianq03UUWGmIDLYyVZsymkTnBibBPxwxoWzfenALo6kEeDUGXCyFibSibU24BtebdP2ialR438RwuG8TnZUIv9k8Ubg/0?wx_fmt=png&quot;); background-size: auto 50px; background-repeat: no-repeat;"></section></section></section><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 0, 0); box-sizing: border-box !important; word-wrap: break-word !important;"> </span><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"> (一)加强组织领导。</strong>各地各有关部门要进一步提高思想认识,把医联体建设作为深化医改的重要内容和增进人民健康福祉的有力举措,切实加强组织领导,建立部门协调推进机制,完善配套措施,确保工作顺利开展。地方各级人民政府要抓紧制定适合本地区医联体建设的实施意见或方案,明确医联体建设目标及时间进度,按时、保质完成工作任务,2017年6月底前各省(区、市)都要明确推进医联体建设的工作方案,10月底前所有三级公立医院都要启动医联体建设工作。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;"> <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"> (二)明确部门职责。</strong>各有关部门要加强统筹协调和联动互动,及时出台配套文件,发挥政策的叠加效应,保证改革措施有效落实,以医联体建设为抓手促进公立医院改革、医保支付方式改革、分级诊疗制度建设等体制机制创新。卫生计生行政部门和中医药管理部门要加强对医联体建设的监管,明确医联体组织管理和分工协作制度,牵头制定相关技术文件。发展改革(价格)部门要完善医药价格政策。科技部门要会同卫生计生行政部门支持国家临床医学研究中心建设,促进医联体发展。财政部门要按规定落实财政补助政策。人力资源社会保障部门要加强医保医疗服务监管,推进医保支付方式改革,完善绩效工资分配机制。国家开发银行要发挥开发性金融“投贷债租证”综合金融服务优势,支持医联体及相关基础性建设。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(三)加强督查评估。</strong>国家卫生计生委要会同各有关部门通过调研、专项督查、定期评估等方式,及时掌握工作进展,指导各地有序推进医联体建设,保障医疗质量安全。要给各地改革探索留出空间,及时总结推广有益经验,发挥典型带动作用,调动地方积极性。各省级卫生计生行政部门要会同有关部门建立医联体效果评估机制和绩效考核方法,综合评估质量、安全、效率、经济与社会效益等因素,以强基层为重点,严格落实责任制和问责制,增强大医院帮扶基层和控制不合理医疗费用的动力。要坚持问题导向,防止和破解大医院垄断资源、“跑马圈地”、“虹吸”基层资源、挤压社会办医空间等问题。</p><p style="margin-bottom: 15px; max-width: 100%; min-height: 1em; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">  <strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">(四)强化宣传培训。</strong>地方各级人民政府要开展医疗机构管理人员和医务人员的政策培训,进一步统一思想、形成共识。要充分发挥公共媒体作用,加强对分级诊疗和医联体建设的宣传,提高社会认可度和支持度,引导群众改变就医观念和习惯,逐步形成有序就医格局。</p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p></section></section></section></section></section></section><p style="max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-family: &#39;Hiragino Sans GB&#39;, &#39;Microsoft YaHei&#39;, Arial, sans-serif; font-size: 16px; white-space: normal; line-height: 28.8px; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><img class="" data-ratio="0.046875" src="http://mmbiz.qpic.cn/mmbiz/ianq03UUWGmKcoRiaRFUGwEKsUmhNrlib04kO9vibINnOibSt6NbibgILWic6cYWXUXesjXWhw1iaXt9hWfkmcniaSXCN7A/0?wx_fmt=jpeg" data-w="640" style="margin-right: auto; margin-left: auto; color: rgb(0, 1, 5); font-family: 微软雅黑; text-align: justify; font-size: 14px; line-height: 22.4px; display: block; clear: both; box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"  /></p><p style="max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-family: &#39;Hiragino Sans GB&#39;, &#39;Microsoft YaHei&#39;, Arial, sans-serif; font-size: 16px; white-space: normal; line-height: 28.8px; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><br  /></p><p style="max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 16px; white-space: normal; line-height: 25.6px; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="max-width: 100%; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; text-indent: 0em; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">地址:广州市天河区银利街银利茶叶博览中心E栋4楼E4030室 &nbsp;&nbsp;</span><span style="max-width: 100%; font-family: Arial, Verdana, sans-serif; text-indent: 0em; font-size: 14px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">&nbsp; &nbsp;&nbsp;</span></p><p style="max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); text-indent: 0em; white-space: normal; font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; 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box-sizing: border-box !important; word-wrap: break-word !important;">公司官网:http://gb.parts-ultrasound.com/</span><span style="max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;"></span></p><p style="max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 16px; white-space: normal; line-height: 24.381px; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="max-width: 100%; line-height: 1.75em; text-indent: 0em; font-size: 14px; font-family: Arial, Verdana, sans-serif; box-sizing: border-box !important; word-wrap: break-word !important;">微信公众帐号:</span></p><p><img data-s="300,640" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz_jpg/dx3KibwtDhvfh2wVX4NftfnfjcZWIKK6EQDWtTTsYwjfQBnsqkThAZP5OlDmg5S3g22gSqMWhAxr2O4MydSJHnQ/0?wx_fmt=jpeg" data-ratio="1" data-w="258"  /></p><p><span style="font-family: Arial, Verdana, sans-serif; font-size: 14px; line-height: 1.75em; 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