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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。
Faced with a series of social problems such as the high medical expenses in our country, the shortage of medical resources and the unfair distribution, the accelerated aging of the society and the low quality of the public health, the establishment of a comprehensive grading system and the vigorous development of community health services have become the reform of the medical and health system in the new era The direction and focus. As a new form of community health service, family beds, which are suitable for medical treatment or rehabilitation in the home environment, and the familiar families as the main places for medical care and nursing, can not only effectively alleviate the shortage of medical resources in large general hospitals , The difficulty of hospitalization for patients, but also brought economic and convenient health services to the general public, improved the medical environment and received the welcome and praise of community residents. However, due to the late implementation of our country’s family beds, the imperfect service system and lack of experience, the problems existing in the practice of family beds have become increasingly prominent, limiting the development and further development of their own roles. This article mainly points out the four major legal problems in the practice of family beds in terms of the conflict between the family sickbed and the existing laws, the legal liability risk of family beds, the legal effect of the agreement to build beds, and the funding guarantee of family beds. At the same time, some suggestions and countermeasures such as practicing physician multi-point practice, controlling the legal liability risk, strengthening the protection of medical staff’s rights, enlarging the scope of medical insurance and so on are put forward. Finally, the conclusion that the sustainable development of family beds needs the support of corresponding laws, regulations and guidelines and policies, With a view to promoting the management of family beds adapted to China’s national conditions and the development of the times as soon as possible, China’s grading medical treatment model and community health service system will be perfected.