CAJ | 학술논문

我国西部经济相对不发达的县级地区普遍面临着县域内医疗服务体系碎片化，乡镇卫生院医疗卫生服务能力严重不足的问题。在有限的公共财政资源约束下，如何提高乡镇卫生院服务能力，改善医疗服务体系的服务质量、连续性和便利性成为我国县级医疗卫生体系改革的现实挑战。本文以青海省湟中县为典型案例，调研当地通过医疗服务联合体纵向整合县域医疗资源的改革实践，分析其行政管理一体化、人力资源整合、双向转诊、信息系统互联互通以及资源与检查结果共享等方面的改革措施及相应结构特点，为我国类似地区改革提供参考案例。
아국서부경제상대불발체적현급지구보편면림착현역내의료복무체계쇄편화，향진위생원의료위생복무능력엄중불족적문제。재유한적공공재정자원약속하，여하제고향진위생원복무능력，개선의료복무체계적복무질량、련속성화편리성성위아국현급의료위생체계개혁적현실도전。본문이청해성황중현위전형안례，조연당지통과의료복무연합체종향정합현역의료자원적개혁실천，분석기행정관리일체화、인력자원정합、쌍향전진、신식계통호련호통이급자원여검사결과공향등방면적개혁조시급상응결구특점，위아국유사지구개혁제공삼고안례。
The fragmentation of health care system within a county and serious capacity constraints of health-care services in township health centers are generally the most significant problems facing underdeveloped counties in western China. Under constraints of limited public financial resources, how to increase service capability of township health centers and improve service quality, continuity and convenience of health care system has become one of the most severe challenges in implementing China’s county health care system reform. This paper takes Huangzhong coun-ty, Qinghai province as a case study. It investigates how the locals use health care alliance to vertically integrate county health care resources during reform implementation, analyzes various aspects of reform measures and the corre-sponding structural characteristics such as the integration of administrative management, integration of human re-sources, dual diagnosis referral, interoperability of information systems, sharing of resources and test results, etc. , and provides similar China’s counties with a case study to be used for reference.