【摘要】 安徽省金寨县通过压实政府办医责任、优化医疗资源布局、实施“八统一”管理模式和多元绩效激励机制等措施，推进紧密型县域医共体建设，显著提升县域医疗服务能力和医保基金使用效率，形成“三医协同、上下联动”的运行格局。与此同时，安徽省金寨县也面临基层人才队伍稳定性差、分级诊疗缺乏刚性约束及医保政策衔接不畅等共性难题。基于金寨县紧密型县域医共体建设实践经验，提出优化“三医”协同治理、明确县域医疗分工、深化医保支付方式改革与激励机制重塑等政策建议，为全国紧密型县域医共体建设提供有益借鉴与参考。更多还原

【Abstract】 Jinzhai County in Anhui Province has promoted the construction of a tightly integrated county medical alliance by strengthening governmental responsibility for running public healthcare institutions,optimizing the allocation of medical resources,implementing an “eight unifications” management model,and establishing diversified performance incentive mechanisms.These measures have significantly improved the capacity of county-level healthcare services and the efficiency of medical insurance fund utilization,forming an operational framework characterized by coordinated development of medical services,medical insurance,and pharmaceuticals,as well as vertical linkage across different levels of healthcare institutions.At the same time,Jinzhai County still faces common challenges,including instability in the grassroots healthcare workforce,the lack of rigid constraints for hierarchical diagnosis and treatment,and insufficient coordination of medical insurance policies.Based on the practical experience of Jinzhai County in developing a tightly integrated county medical alliance,this study proposes policy recommendations including optimizing coordinated governance among medical services,medical insurance,and pharmaceuticals;clarifying the division of responsibilities within county-level healthcare systems;deepening reform of medical insurance payment methods;and restructuring incentive mechanisms.These insights provide useful references for the development of tightly integrated county medical alliances nationwide.更多还原