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[1]殷文兵张凤琴符义亮张智娟何洋杨铭.三级协同模式在县域慢性病管理中的探索实践[J].中国卫生质量管理,2026,33(3):75-79.[doi:10.13912/j.cnki.chqm.2026.33.3.17]
　YIN Wenbing,ZHANG Fengqin,FU Yiliang.Practical Exploration of the Three-Tier Collaborative Model in County-Level Chronic Disease Management[J].Chinese Health Quality Management,2026,33(3):75-79.[doi:10.13912/j.cnki.chqm.2026.33.3.17]

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三级协同模式在县域慢性病管理中的探索实践

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 33 期数: 2026年3期页码: 75-79 栏目: 基层卫生质量出版日期: 2026-03-15

Title:: Practical Exploration of the Three-Tier Collaborative Model in County-Level Chronic Disease Management

作者:: 殷文兵张凤琴符义亮张智娟何洋杨铭; 安徽省庐江县人民医院

Author(s):: YIN Wenbing; ZHANG Fengqin; FU Yiliang; Lujiang County People’s Hospital

关键词:: 慢性病管理; 县域医共体; 三级协同模式; 县医返村; 家庭医生; 医防融合

Keywords:: Chronic Disease Management; County Medical Community; Three-Tier Collaborative Model; County Doctors Returning to Villages; Family Physician; Medical-Prevention Integration

分类号:: R197.1

DOI:: 10.13912/j.cnki.chqm.2026.33.3.17

文献标志码:: B

摘要:: 聚焦慢性病管理“全周期、连续性、协同性”理念，探索实施“目标—分工—支撑—创新”四维联动的“县医院—乡镇卫生院—村卫生室”三级协同慢性病管理模式，通过明确分工、药品“五统一”管理、搭建信息平台、建立激励机制等基础建设，以及转诊“绿色通道”、家庭医生“1+1+1+”模式、“县医返村”等机制深化，形成慢性病闭环管理体系，提升了慢性病管理能力，为同类地区提供了路径参考。

Abstract:: Focusing on the concepts of "full-cycle, continuity, and collaboration" in chronic disease management, this study explores the implementation of a three-tier collaborative chronic disease management model involving "county-level hospitals, township health centers, and village clinics" through a four-dimensional linkage approach of "objectives-division of labor-support-innovation". By establishing foundational measures such as clarifying division of labor, implementing "five unifications" in pharmaceutical management, constructing an information platform, and establishing incentive mechanisms, along with innovative mechanisms including a referral "green channel", the "1+1+1+" family doctor model, and the "county doctors returning to villages" initiative, a closed-loop management system for chronic diseases has been formed. This approach has enhanced chronic disease management capabilities and provided a path reference for similar regions.

参考文献/References:

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更新日期/Last Update: 2026-03-15