The hierarchical diagnosis and treatment was proposed as early as the beginning of the new health care reform.At present,health care reform has entered a decisive phase.How to deal with the problems such as big hospitals are overcrowded with patients while in basic medical institutions there are idle funds,facilities and personnel? Why is it difficult to implement hierarchical diagnosis and treatment? This is the issue that health care reform must face.The experience of the pilot provinces and counties in China has shown that the allocation of medical resources,transformation of medical service model and habit of people seeking medical service and the operational and management performance of medical institutions need to be redesigned and adjusted.In the transitional period of system modification,mechanism building and structure adjustment,with the Intemet mobile technology,considering the difficulties in hierarchical diagnosis and treatment,taking full advantage of the information technology,what should be done to enlarge and extend quality resources from the superior medical body,to realize the information interconnection between provincial and district hospitals,to adopt the model of medical insurance,hospital and drug industry co-development,and to develop grassroots institutions.The ultimate goal of health care reform is to realize information mobility for doctors and patients by technical means to guarantee the basic hospital diagnosis and treatment.%分级诊疗早在新医改之初就已提出.当前,医改已进入了攻坚期,如何解决大医院人满为患、基层医疗机构资金、设备、人员闲置等问题,为什么分级诊疗困难重重、难以落实,这是医改必须直面的课题.我国试点省县的经验表明,医疗资源延伸配置,医疗服务模式转变,群众寻医问药的习惯改变,增强医疗机构管理运营绩效等都需要重新设计调整.在改体制、建机制、调结构的转型时期,如何利用互联网技术,针对分级诊疗的难点,发挥信息技术的优势,让上级医院优质资源放大延伸,医联体内省、县医院信息互联互通、三医联动、做强基层.实现医生、病人不动信息动,以技术手段保障基层医院诊疗水平是医改的终极目标.
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