不孕症双向转诊体系的建设

Construction of a Dual Referral System for Infertility Treatment

目的:实践和推广实用、合理的不孕不育诊治双向转诊体系,解决卫生系统中双向转诊体系建设问题。方法:建立不孕不育诊治规范流程;建立不孕不育病因初筛临床路径;运用电子化管理数据库系统;多次的学习班培训,为期3个月的进修;巡回讲座;专家出诊;设立绿色通道;设立不孕不育门诊示范点。结果:2006—2008年8个门诊点不完全统计转诊患者573人次,转诊率8.8%(573/6 501)。2009年10个门诊点转诊患者447人次,转诊率2.88%(447/15 527)。2005—2010年9月通过绿色通道接受转诊患者648人次;专家出诊44次,接诊1 240人次;实际参加为期3个月进修培训人员133人次;学习班举行16次,参加人员1 223人;设立不孕不育门诊点27家;参加数据库系统学习32家单位。结论:不孕症双向转诊体系的建设取得了很好的效果,已经在江苏省内建立了不孕不育规范化诊治流程,建立了不孕不育病因初筛临床路径,对减少不孕症患者来回奔波、减少医疗开支有切实可行的意义。

Objective：To construct and promote a dual referral system of infertility diagnosis and treatment in a reasonable and practical manner,and try to solve the problems of construction of dual referral systems in sanitary system,as a exploratory stage.Methods：The standardized diagnosis and treatment procedure of infertility and sterility and the clinical pathway of preliminary screening on the pathogeny of fertility and sterility were established.The database system of electronic management was put into practice which was developed in our center and named CCRM.The advanced training course of 3 months＇ duration,together with the lecture circuit and experts out-calls,was held.The clinical shortcut service system,so called Green Channel Clinic,and the demonstration clinics were set up.Results：The preliminary statistics,from 2006 to 2008,showed that the number of referrals reached 573 person-time from the eight outpatient clinics,with the referral rate of 8.8%（573/6 501）.In 2009,the referrals was 447 person-time from the 10 outpatient clinics,with the referral rate of 2.88%（447/15 527）.From January 2005 to September 2010,the number of referral patients accepted by Green Channel Clinic was 648;the experts out-call times was 44,and the number of accepted referral outpatients was 1 240;133 trainees finished their three-months＇ advanced training program;the training courses were held up to 16 times with 1 223 participants;27 outpatient clinics of infertility and sterility were set up;32 hospitals joined in the training of the database system.Conclusions：It is concluded from our practice that good results were achieved on effective infertility diagnosis and treatment due to the construction of the infertility dual referral system.By establishment of the standardized fertility diagnosis and treatment procedure and the clinical pathway of preliminary screening on the pathogeny of fertility and sterility,patients＇ medical cost was reduced,patients＇ difficulty in access to high-quality medical services was relieved,significance of the dual referral system was embodied.