南宁市区双向转诊“下转难”的原因与对策研究

On the Causes of "Lower Referral Difficulty" under the Two-way Referral and Its Countermeasures in Nanning City

本文课题组通过查阅资料、问卷调查、访谈相关人士等方法,对南宁市区双向转诊"下转难"的情况开展了调查研究,并分析得出其原因在于体制不顺畅、机制不到位、政策受限制、基层医疗卫生机构服务能力有限和患者就医习惯等,进而针对性提出若干对策:创新体制,探索区域性医疗联合体运行模式和三级医院门诊下沉到社区模式;创新机制,建立居民健康"守门人"制度和"守门人"责任考核制度,建立双向转诊激励引导机制;创新服务模式,打通双向转诊的各环节,提高社区卫生机构的服务能力;加大媒体宣传力度,扩大社区卫生服务的影响力,营造有利于医疗机构上下联动分工协作的舆论氛围。

After carrying out investigation and study on ＂lower referral difficulty＂ under the two-way referral in Nanning city through data access, questionnaire and the interview of relevant personage, the research group find out the following causes： the system is not smooth, the mechanism does not reach the designated position, policy limitation, grassroots medical institutions service ability is limited and the patients＇ hospitalizing habits, etc.. Then the article puts forward some targeted countermeasures： institutional innovation to explore the regional medical association operation mode and tertiary hospital outpatient service＇ extending to the community; mechanism innovation to build gatekeeper system of residents＇ health, the gatekeeper responsibility appraisal system, and two-way referral incentive mechanism; service mode innovation to open each step of two-way referral, and im- prove community health service capacity; increasing media propaganda, enlarging the influence of community health service, and creating public opinion atmosphere for linkage collaboration of upper and lower medical institutions.