我国医疗联合体激励约束机制的关键问题与路径分析

摘要

通过对我国医疗联合体(以下简称医联体)建设中激励约束机制典型案例的分析,发现目前医联体在激励约束方面存在制度设计不完善、医保支付方式改革缓慢、上下转诊效果不佳、人才资源缺乏和分布不合理、绩效考核和薪酬激励不到位、患者支持度不高等问题,并从顶层设计、医保制度、人事薪酬制度和畅通双向转诊机制4个方面对医联体激励约束机制实施路径提出政策建议.%An analysis of typical cases of the incentive-restraint mechanism in the development of medical alliances in China , discovered a number of problems as follows .These include poor top-level system design, delayed reform of the medical insurance payment system , poor performance of the two-way referral system, insufficient human resources and their unreasonable distribution , shortage of a performance appraisal and salary incentive system, and low patient support.In this regard, this paper put forward policy recommendations on the pathway to carry out the incentive and constraint mechanism of medical alliances , in terms of such aspects as top-level system design , medical insurance system , personnel and remuneration system, and two-way referral system .