The legal problems and countermeasures of hospital at home
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摘要: 面对我国医疗费用居高不下、医疗资源紧缺且分配不公平、老龄化社会加速以及国民健康素质低下等一系列社会问题,建立健全分级诊疗体系,大力发展社区卫生服务已经成为新时期医疗卫生改革的方向和重点。而家庭病床作为一种新型的社区卫生服务形式,选择适宜在家庭环境下进行医疗或康复的病种,以患者熟悉的家庭作为医疗和护理的主要场所,不仅能有效缓解大型综合医院医疗资源紧张、患者住院难的问题,而且给广大居民带来了经济、便捷的卫生服务,改善了就医环境,受到了社区居民的欢迎和好评。但由于我国开展社区家庭病床较晚,服务体系不完善且缺乏经验,使得家庭病床在实践中所存在的问题日益凸显,限制了其本身作用的发挥和进一步发展。本文主要从家庭病床在人员配备上与现行法律的冲突、家庭病床存在的法律责任风险、建床协议的法律效力以及家庭病床的经费保障等方面指出家庭病床在实践中存在的四大法律问题,同时提出实施医师多点执业、控制法律责任风险、加强医务人员权利保障、扩大医疗保障范围等相应的建议和对策,最终得出家庭病床的可持续发展需要相应法律法规和方针政策支撑的结论,以期推动适应我国国情和时代发展的家庭病床管理规范尽快出台,完善我国的分级诊疗模式和社区卫生服务体系。Abstract: Faced with the challenges of high medical costs,unreasonable distribution of much needed medical resources,the aging society and the low national health quality,Hierarchical Diagnosis System and Community Health Service will be still the main direction and focus of health care reform in China.As a new form of Community Health Service,Hospital at Home,which chooses suitable patients to be treated at home,not only relieve the difficulty to be in large general hospital,but also takes economical and convenient health service to the residents,and improves the surroundings of medication.It is well assessed by people.However,due to the short duration and the lack of service institutions or experience,the problems of Hospital at Home have been emerged onto surface,which also limit the effect and further development of itself.In order to push to formulate an advance Hospital at Home Management Practice accommodating to the situation of China,and perfect the institutions of Hierarchical Diagnosis System and Community Health Service,this article analyses four legal problems in Hospital at Home,including the conflict between stuff and law,the legal risk,the legal authority of protocol and the funding guarantees.Meanwhile,the appropriate measures are suggested,such as multi-site physician practice,the risk control of legal responsibility,the protection of medical stuff’s legal rights and expanding the level of medical insurance.In the end,we draw a conclusion that the sustainable development of Hospital at Home needs to be supported by laws and regulations.
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Key words:
- Hospital at home /
- Legal problems /
- Countermeasures /
- Suggestion
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