关键词: 分级诊疗, 监督体系, 资源配置, 试点效果

Abstract: Since the “new medical reform”， China has implemented pilot programs of hierarchical diagnosis and treatment in many places. The reasons for the different effects on the pilots in typical areas are studied in this paper. Based on it， the factors that restrict the implementation of hierarchical diagnosis and treatment are further analyzed. The inherent view and medical culture of patients in primary medical institutions，competition between different levels of medical institutions， imperfect supervision system and lack of information connectivity become major constraints. In response to these problems， some practical reform proposals are put forward， including increasing fiscal investment on medical treatment， strengthening cooperative relations between hospitals， encouraging the people to jointly supervise， guiding patients to choose medical treatment through multiple channels and building a medical information database.

Key words: Hierarchical diagnosis and treatment, Supervision system, Resource allocation, Effect of pilot