台湾、新加坡的双向转诊制度及启示

The Dual Referral System of Taiwan and Singapore and Its Enlightenment

双向转诊不通畅制约我国医疗体系有效运行。为探索影响双向转诊运行的因素,通过调研江西省九江市所辖都昌县、彭泽县、湖口县、庐山区和浔阳区的33所乡镇医院或社区服务站以及九江学院附属医院,发现医生、患者、医院三个主体从各自利益出发影响双向转诊决策。为调和三者利益,保障双向转诊健康运行,必须完善医疗保障体系以发挥其对双向转诊的影响。借鉴台湾地区、新加坡的双向转诊成熟经验,为改善我国双向转诊运行提出健全制度设计、建立协作机制、加强预防保健等政策建议。

The unsmooth dual referral hinders the effective operation Chinese medical system. Through investigating into 33 township hospitals or community medical service stations of Duchang, Pengze, Hukou, Lushan and Xunyang of Jiujiang, and the Affiliated Hospital of Jiu]iang University Jiangxi Province in order to explore the factors influencing the operation of dual referral, the author finds that the three parties of physicians, patients and hospitals influence the dual referral decisions owing to their respective interests. In order to meditate the interests of the three parties and enhance the healthy operation of the dual referral systems, the medical insurance system must be completed to influence the dual referral decisions. Based on learning from the mature experience of dual referral of Taiwan and Singapore, the author puts forward some proposals for Chinese dual referral issues, such as perfecting system design, building coordination mechanism, and strengthening prevention.