三级医院与其下属社区卫生服务机构的双向转诊效果评价

Evaluation on Two-Way Referral Between Hospitals and Their Community Health Services Organizations

目的评价三级医院与其下属社区卫生服务机构的双向转诊效果,探讨三级医院与下属社区卫生服务机构相互之间转诊患者的路径。方法以2007年1月—2008年3月由北京市海淀区永定路社区卫生服务中心及下属4个社区站转往航天中心医院住院的患者、转往各专科专家门诊和由社区医生开具申请单直接到医院交费做大型仪器设备检查的患者为试验组,以2007年1月—2008年3月在航天中心医院门、急诊收住院患者150人为对照组,比较两组院前时间、住院天数、检查费、药费、治疗费、床位费及总费用等数据。结果社区转诊医院患者共计295人次(住院150人次,检查100人次,专家门诊45人次)。两组的院前时间、住院总费用及治疗费比较,差异均有统计学意义(P<0.05)。社区转医院专家门诊以心内科(11/45)、内分泌科(9/45)最多;转医院大型仪器设备检查以B超(48/100)、CT(22/100)、核磁检查(16/100)最多。结论三级医院办社区医疗能实现资源互补,为患者住院、门诊和各种检查提供最大方便。

Objective To evaluate the effectiveness of two-way referral between hospitals and their subordinate community health services（CHS）organizations so as to explore the way to referral of patient between a 3-graded hospital and its subordinate CHS organizations.Methods From January 2007 to March 2008,totally 295 patients transferred from the Yongdinglu CHS center and its 4 subordinate stations in Haiding district of Beijing to the Hospital of Astronautical Clinical College of Beijing University（150 for hospitalization,100 for examination,and 45 for specialist clinic）were enrolled as trial group,and another 150 inpatients from the clinic or emergency department of the Hospital as the controls.Then the data of the patients in the two groups were compared,including pre-hospital time,days of hospitalization,as well as expenses for examination,drug,treatment,bed and the total.Results There were significant differences between the two groups in pre-hospital time,total expense of hospitalization,therapeutic expenses（P0.05）.Among all the 45 patients transferred to specialist clinic,11 went to the cardiology department and 9 to the endocrine department.And among all the 100 patients transferred for examination,there were 48 for B-ultrosonography,22 for CT scanning,and 16 for nuclear magnetic examination.Conclusion The community health service run by a 3-graded hospital can share medical resources,and facilitate greatly patients in hospitalization,clinical and various examinations.