医疗需求强度的提高迫使医疗服务从单一医疗主体供应模式向多医疗主体协同创造价值的整合模式转变，如何在这个涉及复杂影响因素的领域，进行资源协调和运作整合是世界范围难题。我国提出了医疗联合体的解决方案，运行却步履维艰，原因之一是在宏观政策和底层操作之间缺乏有效的策略和具体的方案，无法做到充分理解和有效激发各级医院乃至病人的动力。因此，本研究将首先从医联体影响因素评估和多主体意愿动力分析入手，探索医联体运作的内在动力机理。进一步针对双向转诊和社区首诊两个医联体运作模式的具体问题，从协调机制上探讨社区首诊的保险差异化激励机制和双向转诊的收益共享协调机制，从运作控制上，探索面向社区首诊的预约名额分配策略和面向双向转诊的转诊控制策略，为整合管理提供科学策略和具体可行的方法。最后，本项目将以具体案例分析将社区首诊和双向转诊全流程纳入整体框架，分析关联影响，验证提出的机制和运作策略。

The rapid growth of healthcare demand has been forcing the healthcare service to transform from single facility supply to a new integrated form of multiple facilities coordinating to create value. How to integrate multiple parities in the healthcare system which involves complicated factors is a worldwide challenge. The Healthcare Alliance has been proposed to solve this problem in China, however, the progress is relatively slow. One of the reasons is the lack of effective strategy and detailed method to bridge the macro policy and micro operations. We need sufficient understanding of the motivation of hospitals and patients, as well as effective strategy to cope with them. Therefore, this research will start with the evaluation of factors that influence the Healthcare Alliance’s operation and analysis of multi-entity motivations. We are to explore the natural motivations in the Healthcare Alliance operation. Next, we are to focus on the specific problem of community-first diagnosis and two-way referral, in order to provide scientific strategy and implementable method for integrated management. From view of mechanism, the research will study the differential copayment design for motivating community-first diagnosis and will study revenue sharing coordination for effective cooperation of hospitals in implementation of two-way referral. From view of operation, we are to explore appointment quota allocation to assist community-first diagnosis implementation and referral control to help operation of two-way referral. Finally, this research will combine community-first diagnosis and two-way referral into an integrated framework by case study, to analyze the correlated influence and validate the proposed coordination mechanism and operation strategy.