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全国人大代表华西医院院长李为民:把基层医院建成三甲医院分院

2018-03-03 佚名 华西都市报

今年两会,全国人大代表、四川大学华西医院院长李为民将递交一份“建立‘嵌合式医联体’的建议”。他说,把三级医院的专家、管理、医疗质量水平嵌入到医疗资源欠发达地区的基层医院,形成统一财务管理,统一资源调配,统一薪酬体系,统一业务管理。这样,基层医院便成为三级医院的分院,可以从根本上解决其“造血功能”,老百姓看病难的问题也能够得以根本解决。


今年两会,全国人大代表、四川大学华西医院院长李为民将递交一份“建立‘嵌合式医联体’的建议”。他说,把三级医院的专家、管理、医疗质量水平嵌入到医疗资源欠发达地区的基层医院,形成统一财务管理,统一资源调配,统一薪酬体系,统一业务管理。这样,基层医院便成为三级医院的分院,可以从根本上解决其“造血功能”,老百姓看病难的问题也能够得以根本解决。

杜绝票串串 专家号给“最需要的人”

2月27日,星期二,是四川大学华西医院院长李为民坐门诊的时间。

作为呼吸内科的专家,李为民的号一票难求,有的患者甚至对他说:“李教授,我半年时间都挂不到您的号。”这样的倾诉让李为民心里很不是滋味。有的患者拖家带口、背着干粮,从很远的地方来成都,通宵达旦地排队,就为了能够挂上一个专家号。

2月下旬,华西医院出台了新一轮“专家号预约规定”,所有专家号均通过网络预约,号源在网上公开。这样一来,“票贩子”基本失去了市场。这是华西医院为了规范挂号,第五次重拳出击。“我们要保证老百姓享有公平的就医机会。”李为民说。

很多患者舍近求远跑到大医院看病,根本原因在于对当地的医疗技术没有信心。一次基层调研让李为民印象极为深刻,一个县级医院,取得执业医师资格的只有20余人,无法满足当地老百姓的就医需求。

“我们的目标,是让已诊断明确的慢性疾病患者到基层医院治疗和管理,把大医院的号源留给疑难重症患者。三级医院医生确诊患者病情后,给出相应的疾病管理方案,这对基层医院的医生也是一种指导。”李为民说。

目前,华西医院与成都市成华区的多家社区医院建立了合作,凡是在基层医院就医的患者出现病情异常,基层医生无法解决的时候,可以迅速通过信息沟通机制以及远程医疗网络与华西医院的医生快速取得联系,寻求支持;如果患者确因病情疑难危重需转院到华西医院治疗,华西医院也能够给予绿色通道,保证患者尽可能得到最及时的治疗。

解决“造血功能”基层医生可到三甲医院工作

在李为民看来,只有解决了基层医院的“造血功能”,老百姓的看病难问题才能得以根治。

目前,华西医院与全国640多个医院建立了“医联体”,包括集团式、领办式、专科联盟等,华西医院的医生通过不同形式参与,加入到医联体医院的工作中。但李为民认为,如果不做到管理统一、薪酬体系统一和人力资源调配统一,这样的“医联体”是没有“根”的。

现在,华西医院每年都会派出骨干医生到医联体联盟医院工作,但医生不愿意扎根在基层,往往时间不长。如果改变一种管理模式,把华西医院和基层医院纳入一体化管理,情况会大有改观。

因此,建立“嵌合式医联体”是李为民今年在全国两会上的建议。他以四川省为例,四川省拥有36家三甲综合医院、60个少数民族县。在政府主导下,每家三甲医院可根据自身实际情况与1-2家县级医院建立嵌合式的医联体,实现优质医疗资源精准下沉全覆盖,具有较强可操作性。三级医院将基层医院作为分院来管理,形成功能定位各异、地点分布不同的整体。预算管理、人力资源调配等由三级医院统筹完成,帮扶形式以在线在位相结合为主。同时,建立多劳多得、优劳优得的激励薪酬体系。对于基层医院的医生来说,每2-3年安排在三级医院工作2-3个月,进一步提高业务水平。招聘或引才到基层医院工作满8年以上,并且有出色业绩的医生,根据自愿可以回到内地三级医院工作。只要让人员流动起来,医生的工作积极性就能提高。

建立激励机制 晋升前提要有基层经验

李为民在建议中还提到,建立“民族地区专家级骨干医生履职激励机制”的目的是,切实解决基层专家级医生匮乏的问题。他认为,基层工作经历应该与考核晋升相结合,比如三级医院的医生,如果想要晋升骨干、重要业务岗位或职称,就必须有在基层医院工作的经历。这样一来,专家级医生就能够自愿到基层工作。

华西医院的经验是,对于派驻到基层工作的医生收入能够得到提高,比如在华西医院本部工作,每个月能领1万元工资,那么到基层工作的华西医院医生每个月可以领到12500元。如果实现了三级医院与基层医院的统一管理,那么华西的医生到基层医院工作,就只是把工作地点搬到了华西医院的某一个分院而已。医生流动了,基层医院的医疗技术水平才能够提升,病人才会愿意留在基层医院治疗,老百姓看病难的问题才能解决。

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    2018-04-03 xuyu
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1974118, encodeId=3a5119e4118b9, content=<a href='/topic/show?id=4d9d904e092' target=_blank style='color:#2F92EE;'>#西医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90470, encryptionId=4d9d904e092, topicName=西医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d47b2500175, createdName=12498cf9m35(暂无昵称), createdTime=Wed Jan 23 06:29:00 CST 2019, time=2019-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030704, encodeId=984a2030e0499, content=<a href='/topic/show?id=74e93593852' target=_blank style='color:#2F92EE;'>#华西医院院长#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35938, encryptionId=74e93593852, topicName=华西医院院长)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Fri Jul 20 00:29:00 CST 2018, time=2018-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914078, encodeId=9ed419140e8b2, content=<a href='/topic/show?id=048124e61f7' target=_blank style='color:#2F92EE;'>#人大代表#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24761, encryptionId=048124e61f7, topicName=人大代表)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5462342, createdName=sunmin0219, createdTime=Mon Sep 17 04:29:00 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1675713, encodeId=a91816e57136a, content=<a href='/topic/show?id=868b35630f2' target=_blank style='color:#2F92EE;'>#医院院长#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35630, encryptionId=868b35630f2, topicName=医院院长)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=446427287674, createdName=xuyu, createdTime=Tue Apr 03 16:29:00 CST 2018, time=2018-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365963, encodeId=445e136596315, content=<a href='/topic/show?id=468119e04db' target=_blank style='color:#2F92EE;'>#三甲医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19704, encryptionId=468119e04db, topicName=三甲医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Mon Mar 05 13:29:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1443438, encodeId=3c0c14434382a, content=<a href='/topic/show?id=1e2b41991fc' target=_blank style='color:#2F92EE;'>#基层医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41991, encryptionId=1e2b41991fc, topicName=基层医院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84f65069039, createdName=12498e8em73暂无昵称, createdTime=Mon Mar 05 13:29:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1445891, encodeId=4ae214458912e, content=<a href='/topic/show?id=949e3593330' target=_blank style='color:#2F92EE;'>#华西#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35933, encryptionId=949e3593330, topicName=华西)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/nE4GrbxL2qh8HCfQ9Aic863Ks6MQVCgNnxZib6aVhV679l2JX0YVwulK1GZ3QaOicPXvFNvZHicPicQ95qx3OH9evVw/132, createdBy=cbc15186945, createdName=fengyqf, createdTime=Mon Mar 05 13:29:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552439, encodeId=cecf1552439e9, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Mon Mar 05 13:29:00 CST 2018, time=2018-03-05, status=1, ipAttribution=)]
    2018-03-05 fengyqf
  8. [GetPortalCommentsPageByObjectIdResponse(id=1974118, encodeId=3a5119e4118b9, content=<a href='/topic/show?id=4d9d904e092' target=_blank style='color:#2F92EE;'>#西医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90470, encryptionId=4d9d904e092, topicName=西医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d47b2500175, createdName=12498cf9m35(暂无昵称), createdTime=Wed Jan 23 06:29:00 CST 2019, time=2019-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030704, encodeId=984a2030e0499, content=<a href='/topic/show?id=74e93593852' target=_blank style='color:#2F92EE;'>#华西医院院长#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35938, encryptionId=74e93593852, topicName=华西医院院长)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Fri Jul 20 00:29:00 CST 2018, time=2018-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914078, encodeId=9ed419140e8b2, content=<a href='/topic/show?id=048124e61f7' target=_blank style='color:#2F92EE;'>#人大代表#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24761, encryptionId=048124e61f7, topicName=人大代表)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5462342, createdName=sunmin0219, createdTime=Mon Sep 17 04:29:00 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1675713, encodeId=a91816e57136a, content=<a href='/topic/show?id=868b35630f2' target=_blank style='color:#2F92EE;'>#医院院长#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35630, encryptionId=868b35630f2, topicName=医院院长)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=446427287674, createdName=xuyu, createdTime=Tue Apr 03 16:29:00 CST 2018, time=2018-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365963, encodeId=445e136596315, content=<a href='/topic/show?id=468119e04db' target=_blank style='color:#2F92EE;'>#三甲医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19704, encryptionId=468119e04db, topicName=三甲医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Mon Mar 05 13:29:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1443438, encodeId=3c0c14434382a, content=<a href='/topic/show?id=1e2b41991fc' target=_blank style='color:#2F92EE;'>#基层医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41991, encryptionId=1e2b41991fc, topicName=基层医院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84f65069039, createdName=12498e8em73暂无昵称, createdTime=Mon Mar 05 13:29:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1445891, encodeId=4ae214458912e, content=<a href='/topic/show?id=949e3593330' target=_blank style='color:#2F92EE;'>#华西#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35933, encryptionId=949e3593330, topicName=华西)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/nE4GrbxL2qh8HCfQ9Aic863Ks6MQVCgNnxZib6aVhV679l2JX0YVwulK1GZ3QaOicPXvFNvZHicPicQ95qx3OH9evVw/132, createdBy=cbc15186945, createdName=fengyqf, createdTime=Mon Mar 05 13:29:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552439, encodeId=cecf1552439e9, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Mon Mar 05 13:29:00 CST 2018, time=2018-03-05, status=1, ipAttribution=)]
    2018-03-05 陈吴1239
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