DRGs与双向转诊结合的实践探索

Two-way Referral Practice Based on DRGs

本文分别从DRGs和双向转诊入手,通过文献研究,分析DRGs对于双向转诊的实践意义和难点。DRGs的相关理念、方法和标准可作为构建双向转诊相关制度和指标提供参考,通过指标的制定提升患者诊疗效果的同时,还可通过双向转诊的科学开展节约医疗费用和医保资金。其难点在于实际转诊的适应症,相关补偿措施,完善基层医疗机构的接诊能力,以及患者治疗的连续性。

The practical significance and the existing difficulties were reviewed to realize two-way referral based on DRGs.The author proposed that the concepts,methods and standards of DRGs could be applied as the references in the establishment of two-way referral system and evaluation indices,thus may be benefit to improve the effects of the diagnosis and treatment of patients,at the same time to save the medical expenses and health insurance funds.However,the difficulties were the set of the referral indications,related compensation system,the low service capacity of the primary health care institutions and the insurance of continuity of the care.