北京市社区医生转诊病人原因调查

Surveying the reasons for patients being referred by community doctors in Beijing

目的:了解北京市社区医生双向转诊开展情况及双向转诊的原因。方法:对来自北京市城区的社区医生进行问卷调查。结果:共调查了北京市8个区43个社区卫生服务中心的255名社区医生。社区医生在上转及接受下转患者的比例上有明显差异,85.9%的被调查者曾经上转患者,只有29.4%的被调查者接受过下转患者;上转病人的主要原因是社区无条件检查,其次为诊断不清而需要上级医院进一步明确诊断的;接受下转患者的主要原因是需继续管理已明确诊断的慢性病患者。结论:合理利用医疗资源真正实现双向转诊,需要提高社区医生诊疗水平,加强上级医院医师下转患者的管理。

Objective ： To study the status of two-way referral in community health services （ CHS ） of Beijing and reasons for patients being referred by doctors in CHS. Methods：Doctors in community health services of urban Beijing were surveyed with questionnaires. Results ：255 cases of doctors from 43 CHS centers of 8 urban districts were surveyed. There had obvious difference between up-referral rate and down-referral rate for community doctors, which were 85.9% and 29.4% respectively. The main reason for up-referral was lack of ability to examine ,followed with the reason of confirming diagnosis. And the main reason for down-referral was to keep management on those patients with diagnosed chronic diseases. Conclusion：To make full use of medical resources and realize two-way referral easily, community doctors＇ capability of treating and diagnosing diseases needs to be improved, and management on down-referral patients needs to be intensified.