我国中医社区健康管理模式发展现状与对策研究——基于文献回顾与专家咨询
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摘要
[目的]梳理我国中医社区健康管理模式的发展现状,探讨中医社区健康管理服务的问题和对策,为提出具有中医特色的社区健康管理模式提供参考。[方法]采用文献回顾法,梳理我国中医社区健康管理模式的发展现状;采用专家咨询法,围绕中医特色社区健康管理模式的现存问题和发展对策进行研讨。[结果]目前开展的中医社区健康管理模式可以分为以社区卫生服务机构为主和以社区卫生服务机构为辅两种类型。目前的主要问题包括:服务人群覆盖范围有待拓展、需要纳入的专项技术有待明确、收费标准和收费项目有待尽快开发、服务形式未能多样化发展、服务模式中各级各类医疗机构之间的协作监管机制尚不明确。对策建议包括:根据居民实际需求明确服务范围、对于中医健康管理适宜技术设立准入评估指标和评价体系、联合各类医疗保险增加对中医社区健康管理服务的支撑、开发具有中医特色的社区健康管理服务包、以社区卫生服务机构为核心构建各级各类医疗机构的协作机制。[结论]中医社区健康管理模式中的服务收费、服务提供、服务内容、服务对象和服务机制5个方面存在互相制约和影响,在中医社区健康管理体系的构建过程中,明确区域人群的中医药服务需求是首要任务,以政府为主导,融入市场化运作,通过政府、机构、个人的多方协作,才能充分发挥中医药对健康管理的作用,提高人群的健康水平。
Objective To review the development status of Traditional Chinese Medicine( TCM) community health management mode,discuss the problems and countermeasures of TCM community health management service so as to provide reference for community health management mode in TCM characteristic. Methods The literature review method was used to review the development status of TCM community health management mode. It conducted discussion on the problems and countermeasures of community health management service centering on TCM by expert consultation method. Results There were two main types of TCM community health management mode,which were CHS-led and CHS-subsidiary. Main problem at present included that the coverage of service population should be expanded and the special technology should be clarified,charging standard and charging projects should be developed,services had not diversified development,cooperation supervision mechanism among all or different levels medical institute in service mode was not clear. The countermeasures included that determined service scope according to residents actual demand,established admittance evaluation indexes and evaluation system which appropriated TCM health management service technology,increased the support for TCM community health management service which united all kinds of medical insurance,developed service package of TCM community health management,built cooperation mechanism among all or different levels medical institute at the core of community health service institute. Conclusions The linkages across five sectors of TCM community health management mode are interactive such as service charge,service delivery,service object,service mechanism. In the process of building TCM community health management system,clear-cut TCM service requirement for regional population is the primary task. Take government as the leading role,integrate market operation,cooperation with various devices by government,institute and private so as to give full play the role of TCM in health management and improve health level for the population.
Objective To review the development status of Traditional Chinese Medicine( TCM) community health management mode,discuss the problems and countermeasures of TCM community health management service so as to provide reference for community health management mode in TCM characteristic. Methods The literature review method was used to review the development status of TCM community health management mode. It conducted discussion on the problems and countermeasures of community health management service centering on TCM by expert consultation method. Results There were two main types of TCM community health management mode,which were CHS-led and CHS-subsidiary. Main problem at present included that the coverage of service population should be expanded and the special technology should be clarified,charging standard and charging projects should be developed,services had not diversified development,cooperation supervision mechanism among all or different levels medical institute in service mode was not clear. The countermeasures included that determined service scope according to residents actual demand,established admittance evaluation indexes and evaluation system which appropriated TCM health management service technology,increased the support for TCM community health management service which united all kinds of medical insurance,developed service package of TCM community health management,built cooperation mechanism among all or different levels medical institute at the core of community health service institute. Conclusions The linkages across five sectors of TCM community health management mode are interactive such as service charge,service delivery,service object,service mechanism. In the process of building TCM community health management system,clear-cut TCM service requirement for regional population is the primary task. Take government as the leading role,integrate market operation,cooperation with various devices by government,institute and private so as to give full play the role of TCM in health management and improve health level for the population.
引文
[1]国家卫生计生委.关于印发《国家基本公共卫生服务规范(第三版)》的通知[EB/OL].(2017-3-28)[2018-09-20].http://www.nhfpc.gov.cn/jws/s3578/201703/d20c37e23e1f4c 7db7b8e25f34473e1b.shtml.
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[11]郑访江,王玉珠,刘书斌,等.“治未病”思想指导下的中医健康管理在亚健康状态人群中的应用价值分析[J].内科,2017,12(5):694-697.
[12]陈秀彦,张泽浩,许丰,等.借鉴美国经验探索构建我国面向健康管理的医疗保险制度[J].中国医药导报,2018,15(3):167-170.
[13]王志雄.我国基本公共服务均等化研究[D].北京:财政部财政科学研究所,2011.
[14]张金玉,王志伟,杨曼茹,等.将中医“治未病”纳入国家基本公共卫生服务的探讨[J].世界中西医结合杂志,2016,11(4):560-562,592.
[15]黄守文,吴克昌.中医“治未病”健康管理服务存在的问题与对策探析[J].中医药导报,2017,23(4):41-43.
[16]马洪瑶,申俊龙,徐浩,等.中医药特色社区健康管理的理论依据与路径创新[J].中国全科医学,2014,17(13):1543-1546.
[2]国务院办公厅.关于印发《中医药健康服务发展规划(2015-2020年)》的通知[EB/OL].(2015-05-07)[2018-09-20].http://www.gov.cn/zhengce/content/2015-05/07/content_9704.htm.
[3]白雅婷,韩琳.与中医治未病相结合的健康管理模式研究现状[J].全科护理,2016,14(2):124-126.
[4]张杰,孙晓生.基于“治未病”思想的中医健康管理模式探讨[J].中医药管理杂志,2017,25(23):142-145.
[5]葛敏,江萍,马恰怡,等.上海市长宁区中医预防保健服务体系建设[J].上海预防医学,2016,28(10):746-751.
[6]曹海涛,潘毅慧,刘登.上海市闸北区社区综合健康管理模式研究[J].中国全科医学,2011,14(19):2195-2196.
[7]于海浩,陈晓春.“治未病”背景下身体健康风险评估与干预中心的研究[J].当代体育科技,2015,5(36):252-254.
[8]林欣潮,苏惠萍,练毅刚,等.基于中医养生理论的健康管理思路[J].现代中医临床,2015,22(2):46-49.
[9]黄娟,吴智惠,李乔,等.“治未病”服务在基层的应用[J].当代医学,2017,23(6):181-182.
[10]莫轶晖,许友慧,陈明达.以中医治未病思想为核心的健康管理模式初探[J].中国社区医师,2015,31(4):155-157.
[11]郑访江,王玉珠,刘书斌,等.“治未病”思想指导下的中医健康管理在亚健康状态人群中的应用价值分析[J].内科,2017,12(5):694-697.
[12]陈秀彦,张泽浩,许丰,等.借鉴美国经验探索构建我国面向健康管理的医疗保险制度[J].中国医药导报,2018,15(3):167-170.
[13]王志雄.我国基本公共服务均等化研究[D].北京:财政部财政科学研究所,2011.
[14]张金玉,王志伟,杨曼茹,等.将中医“治未病”纳入国家基本公共卫生服务的探讨[J].世界中西医结合杂志,2016,11(4):560-562,592.
[15]黄守文,吴克昌.中医“治未病”健康管理服务存在的问题与对策探析[J].中医药导报,2017,23(4):41-43.
[16]马洪瑶,申俊龙,徐浩,等.中医药特色社区健康管理的理论依据与路径创新[J].中国全科医学,2014,17(13):1543-1546.
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