代表建议大医院办社区医疗卫生机构 实现阶梯就医模式 Represent advice big hospital community health organizations implement ladder medical model

　　“目前，‘大病进医院、小病在社区、康复回社区的社区首诊、社区与医院双向转诊’的格局远没有形成。如何使社区医疗走出软硬件不配套、有设备缺人才的困局？那就是大医院管办社区卫生机构或社区成为大医院的派出机构。”全国人大代表、保定市卫生局副局长郭淑芹接受记者采访时说。

"At present,‘A serious illness in hospital/Slight illness in the community/Rehabilitation back to the community of the first option/Community and two-way referral hospital’The pattern is far from forming.How to make community health care out of the hardware and software do not form a complete set/Equipment without talent dilemma?Tube that is big hospital community health organizations or community become big hospital local agency."The National People's Congress/Baoding city health bureau deputy director Guo Shuqin told reporters.

　　郭淑芹举例说，去年冬天，保定市各大医院人满为患，而社区服务站的患者没有太大增加，有的甚至比较冷清。虽然当下社区卫生服务中心和服务站比过去面积大了，设备有了，环境好了，但依旧得不到居民信任，病人量上不去，而大医院却人满为患，一床难求。

Guo Shuqin for instance,Last winter,Baoding city each big hospitals are overwhelmed,Patients in community and do not have too big increase,Some even more cold and cheerless.Although the community health service center and service station area is large than in the past,Device has a,The environment is good,But still can not get residents' trust,The amount of patients couldn't get on,And the large hospital is overcrowded,One bed is hard to find.

　　“究其原因还是社区医疗服务机构没有让居民特别信任的医生，因此，多数社区卫生服务机构效能仍处于低水平、低层次阶段，国家投入社区卫生服务机构的钱尚未见到预期效果。”郭淑芹说。

"Investigate its reason, or community health service institutions not let residents especially trust doctors,so,Most of the community health service institutions efficiency is still low/Low level stage,National community health service institutions money has yet to meet anticipated effect."Guo Shuqin said.

　　郭淑芹说，大医院主管社区医疗机构，一方面可以使社区卫生服务的发展从根本上走出困境，提升实力、提高效能，实现优秀医生进社区；另一方面，大医院将一些压床慢性病、术后患者、康复期病人转回社区，可以提高医院的床位周转率。

Guo Shuqin said,Big hospital, director of community medical institutions,On the one hand can make the community health service development fundamentally out of the woods,Improve strength/Improve the efficiency of the,Achieve good doctor into the community;On the other hand,Some big hospitals will press chronic diseases/Postoperative patients/Convalescence patients back to the community,Can improve the hospital beds turnover.

　　“如一般的疝气、阑尾炎、腹腔镜等术后病人三天就可以出院，需要的话回来拆线。但由于存在院外感染、家庭护理不专业等问题，病人一般要住到拆线后。如果医院有自己办的社区，医护人员可放心将其转到社区，医院为社区急、危、重症患者的向上转诊开设‘绿色通道’，术后及康复期患者可转入社区卫生服务机构接受后续康复服务。真正实现‘小病在社区、大病进医院、康复回社区’的阶梯就医形式。”郭淑芹说。

"Such as general hernia/appendicitis/Laparoscopic postoperative patients can be discharged three days,Take out stitches need to come back.But due to exist outside the hospital infection/Home care is not professional,The patient must stay after take out stitches to the general.If you have any of the community hospitals,Medical personnel to safely transfer them to the community,Hospital to the community/danger/Critically ill patient referral to open up‘The green channel’,Patients with postoperative rehabilitation and can turn into community health services institutions accept follow-up rehabilitation services.truly‘Slight illness in the community/A serious illness in hospital/Recover back to the community’The ladder of medical treatment form."Guo Shuqin said.

　　郭淑芹建议，每个大医院主管辖区内一定数量的社区医疗机构。大医院管办社区医疗管理形式视投资主体的不同可分为两种，一是大医院接管，人事管理、财务管理、医疗管理等一体化。二是由医院托管或与医院挂靠，共享技术、统一管理。大医院在管理社区医疗机构中，国家给社区医疗机构的拨款单设账户，专款专用，按照各地卫生行政主管部门的要求，统一配备设施设备等硬件，保证建设社区医疗卫生事业的钱用到社区医疗服务上。(记者白林、王昆)

Guo Shuqin advice,Each big hospital director of a number of community medical institutions within their respective jurisdictions.Big hospital management community health management form depending on the different investment subject can be divided into two kinds,Is a large hospital to take over,The personnel management/The financial management/Integration of health management, etc.2 it is managed by the hospital or affiliated with a hospital,Sharing technology/Unified management.Big hospital in the management of community medical institutions,Country to the community medical institutions the appropriation account set up separately,Special funds for special purpose,In accordance with the requirements of the local health administrative departments,Unified equipped with facilities such as hardware,To ensure that the construction of community health cause money used on community medical services.(The reporter gobelin/Wang Kun)