目的 结合江西省卫生事业发展的现实情况,研究江西省城市社区卫生服务发展的背景和必要性.方法 在对江西省医疗卫生服务机构进行系统调研的基础上,采用彼得·圣吉的系统基模分析技术,对发展城市社区卫生服务的必要性进行反馈系统基模分析.结果 建立了制约江西省卫生事业发展的四个增长上限基模:卫生资源配置不合理制约医疗事业发展的增长上限基模；老龄化制约医疗事业发展的增长上限基模；疾病谱变化制约医疗事业发展的增长上限基模；大中型医院“人满为患”制约医疗事业发展的增长上限基模.并提出解除制约因素促使系统发展的管理对策:发展社区卫生服务,卫生资源向基层下沉；建立健全老年人卫生服务体系；有效预防、控制慢性病；建立合理的双向转诊制度,促进患者合理分流.结论 为了进一步促进江西省卫生事业的健康、可持续发展,有效缓解“看病难,看病贵”问题,必须大力发展社区卫生服务.%Objective onto study the background and necessity of community health service (CHS) development in urban areas of Jiangxi province through combining the real condition of health cause development. Methods On the basis of systemic investigation of medical health service institutions of Jiangxi Province, the archetype analysis of feedback system was conducted on the necessity to develop urban CHS by applying system archetype analysis of Peter Senge. Results We built four limits - to - growth archetypes of medical cause development restricted by rational distribution of health resource, aging of population, alteration of disease spectrum, and overcrowding in large or meddle hospitals. And we also put forth the management counter-measures to resolve the restrictive factors and promote system development; promoting community health service and allocating more health resource to the grassroots, establishing and improving the health service system for elderly people, effectively preventing and controlling chronic diseases, and building reasonable two - way reference system and promoting reasonable shunt of patients. Conclusion In order to improve the medical sustainable development in Jiangxi province and effectively alleviate the difficulty in seeing a doctor and high medical cost, it is very important to the government to lay high emphasis on development of CHS.
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