我国双向转诊运行现状与效果的系统综述

Status and Effect of Two-way Referral System in China:A systematic review

目的了解我国目前双向转诊实施的现状及效果,发现问题并提出建议,从而为我国进一步完善双向转诊制度提供参考依据。方法采取系统综述的研究方法,确定"双向转诊+现状"、"双向转诊+效果"为检索词,查阅相关资料,共得到文献307篇,通过严格的纳入排除标准,最终采纳文献43篇,对所得资料进行系统描述。结果目前我国双向转诊发展较为迅速,转诊人数有所增加,转诊质量得到明显改善,但仍存在一定问题,其中以上转容易下转难、社区卫生服务机构服务质量差、相关制度不完善、转诊流程不明确、缺乏激励监督机制等问题较为突出。结论政府应完善落实双向转诊相关政策,医疗机构内部应加强监督管理力度、发展公共信息平台,完善转诊流程,促进双向转诊的发展。

Objective To study the present situation and effect of the two-way referral system in China,find out problems and put forward some suggestions so as to provide a reference for further improvement of two-way referral system in China.Methods Systematic review is used.＂Two-way referral system＂,＂current situation＂ and ＂effect＂ were taken as key words to research literature.Through the strict exclusion standard among 307 articles 43 were enrolled.The retrieved data were described by systematic review.Results The development of two-way referral in China has been rapid,and the quantity and quality of referral were increased obviously,but there are still some problems such as upward-referral being easier but downward referral being difficult,poor quality of service in community health institutions,imperfect relative system,unclear referral flow,lack of the incentive mechanism and supervision.Conclusion The government should implement some supporting policies for two-way referral system,and the medical institution should strengthen internal supervision and management.The public information platform should be developed,and referral flow be perfected so as to promote development of two-way referral system.