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山东省医联体建设 济宁做法很有范儿

2017-05-24 李倩 康宇 齐鲁壹点

近年来,济宁积极探索创新,涌现出精准医疗“同质化”服务网络、单病种控费、临床路径管理等具有济宁特色的创新举措。

我省的地方医联体建设形式多样、因地制宜,实现纵向整合区域内医疗资源,通过构建以患者为核心的医疗、康复和护理等一体化的医疗服务链条,实现医联体内服务的连续性。济宁在这方面有值得其他地市学习的地方。

全省医联体建设,济宁做法很有范儿

在23日的全省医联体建设及临床路径管理培训班上,济宁市卫计委主任焦华介绍了济宁的情况,济宁市第一人民医院、济医附院的两位院长分别从医联体建设、分级诊疗以及临床路径管理等方面介绍了各自做法、成熟的经验。与会代表们还现场观摩了两家医院的先进设施和先进做法。



焦华介绍,加快医联体建设、实施临床路径管理是深化医改的重要内容。近年来,济宁积极探索创新,涌现出精准医疗“同质化”服务网络、单病种控费、临床路径管理等具有济宁特色的创新举措,在提升各级医疗机构质量效益的同时,也让群众普遍受了益、得了实惠。2015年以来,济宁建立以市第一人民医院为区域医疗中心,140余家县乡医疗机构参与的“同质化”服务网络,县域内首诊率达93.67%、互联网远程诊断373789人次,初步形成基层首诊、分级诊疗、急慢分治、双向转诊的诊疗模式。这一做法于2016年9月被山东省卫计委予以全省推广。

山东省卫计委相关负责人表示,省内开展的分级诊疗工作和医联体建设,充分考虑了城乡二元化社会结构、区域经济社会发展水平不平衡、医疗服务价格支付差异化、医疗服务供给主体多元化、病人就医格局无序等现状,在总结地方医联体建设经验的基础上,采用城乡分开、专科联盟、远程协作等多种形式开展医联体建设工作。如青岛市三大医疗集团通过管理、技术、人才、信息等纽带构建集团;如高密市组建县域医共体,实行县乡一体化管理;如北京儿童医院医联体组建专科联盟;如济宁市第一人民医院组建影像、心电、病理、检验医技远程诊断中心,面向基层、偏远和欠发达地区构建远程医疗协作网等等。

相关链接:

医疗数据多跑腿,患者省了不少事

在县级医院拍的X光片,上传到济宁市第一人民医院医学影像诊断中心,最快1小时内即可收到三甲医院专家出具的诊断报告。这种做法让患者少跑腿,让数据多跑腿,患者看病省了不少事。

为让基层、偏远乡镇的患者享受到三甲医院的优质服务,济宁市第一人民医院先后投资2500余万元建设医疗智慧云平台,先后与县市区综合医院、中医院、妇幼保健院等医联体单位实行远程会诊,建立济宁市心电诊断、影像诊断、检验诊断、病理诊断远程会诊中心。

搭乘上全市医学影像诊断中心这个便车,基层医院的卫生技术人员也尝到甜头。2016年7月,兖州中医院影像诊断科的医生到市一院驻点学习,“之前那些技术方面的短板,潜移默化中都得到了提高。”兖州中医院影像诊断科一名医生说,回去再服务辖区患者,咱心里更有底气了。

医疗技术服务水平提升了,基层医疗机构的收费标准并没增加。三甲医院和基层医疗机构的互联共享模式,节省了患者的看病时间,也给患者省下不少钱。  济宁市第一人民医院院长孙树印介绍,目前心电诊断已覆盖132家医院、医学影像诊断已覆盖130家、病理诊断已覆盖10家医院,日均会诊500余人次。2017年1至4月已累计完成心电诊断3.92万例,阳性率65%,影像诊断1.12万例,初步建立同质化医疗服务体系。基层医院患者首诊率提高20%,检查费用降低约30%。

临床路径复合化,36万多患者受益

2010年3月以来,济宁始终将开展临床路径作为公立医院改革内容的重点,引导全市二级以上医疗机构结合医院工作实际选择部分专业病种开展临床路径试点工作。济医附院作为国家首批临床路径管理试点单位,在单病种控制、临床路径管理、JCI评价等方面探索出了科学、先进、适应实践的经验做法。

“临床路径的管理是一个持续改进的过程,经历了从简单病种到复杂病种,从单纯诊疗技术路径到诊疗技术实施、优质护理服务、质量控制、疾病与健康管理等工作标准为一体的复合路径模式。”济医附院院长陈东风介绍。

截至2016年,医院共完成临床路径管理出院病人36万余例,实施337个病种的457个临床路径,科室覆盖率100%,55.6%的出院病人完成临床路径管理。医院联合医保部门对医保住院起付和结算衔接、联审和医疗信息共享,探索了269个病种的单病种付费改革,对不同等级医院实行不同报销政策,引导群众到基层就医。通过实施临床路径管理,保证了治疗的精细化、标准化、同质化,加强临床诊疗过程的风险控制,有效降低医药费用。

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    2017-05-24 changjiu

    好经验值得借鉴

    0

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    2017-05-24 139****5926

    好文章学习了

    0

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