针对当前“大病不出县”目标和县级公立医院规模调控政策相矛盾，城市优质医疗资源下沉与基层医疗服务需求衔接不紧密，托管费用和基层医院运行发展存在冲突，双向转诊制度设计间缺乏衔接问题，提出强化县域医疗卫生资源配置，提升县域医疗卫生服务能力；借助卫生信息化，精准对接基层服务需求；完善优质资源下沉保障机制，确保双方医院的可持续发展；破解基层医疗人才短缺政策瓶颈，推进分级诊疗制度实施的思考与建议。%In order to solve the current problems including the contradiction between target of"serious illness treated in county"and policy of scale control of county-level hospitals, the insufficient connection between urban medical resources sinking and requirements of grassroots medical services, conflicts between trusteeship expenditure and the development of hospital as well as connection problems of dual referral system, medical and health resource allocation as well as medical and health services ability at county level should be improved;the requirements of grassroots medical services could be fulfilled by the utilization of health information system; guarantee mechanism of quality resources sinking should be optimized to ensure the mutual sustainable development of hospitals;policy bottle-neck of the shortage of grassroots medical and health personnel should be resolved so as to promote the implementation of hierarchical medical system.
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