二级医疗机构医保转诊病人的病因分析及相关研究

Pathogeny analysis and its factors of referral of Social Medical Insured patients in secondary hospital

目的:通过对二级医疗机构医保转诊病人的病因分析,探讨当前二级医疗机构建设和发展的方向以及建立合理转诊机制的必要性。方法:根据某县3年来医保住院及转诊病人的信息资料,进行疾病分科检索和数据处理并归纳出转诊的主要病因。结果:医保患者转诊的病因分布广泛,涉及临床各科及各系统疾病,但以肿瘤、心脑血管和肝胆胰疾病为主,眼科、五官科疾病也是常见病因。结论:二级医疗机构的建设应紧密联系医学科学技术的发展和患者对诊疗技术多样化的需求,而建立合理的医保转诊机制也是必要的。

Objectives： To explore the necessity of building rational referral mechanism and the way of secondary hospital development through SHI referral patient pathogeny analysis. Methods： SHI referral patient information in one county in the current 3 years was collected. The pathogeny was analyzed by diseases classification. Results： SHI referral patient pathogeny was focused on cancer, heart disease, cerebrovascular disease, liver, gall and pancreas disease. Eye disease was also the familiar reason for referral. Conclusions： Secondary hospital development should meet the patients demand and follow up medical technology development. Building rational referral mechanism was necessary.（The 1st People Hospital, Huoqiu County, Huoqiu County, Anhui Province, 237400, PRC）