上海某社区卫生服务中心与公立医院合作探讨

Study of the cooperation between the public hospital and some community health service center in Shanghai

目的 :了解公立医院对龙华社区卫生服务中心医疗支援与合作的情况,分析在合作过程中存在的问题并提出建议。方法 :总结2013年6月至2014年5月,龙华街道社区卫生服务中心设立二、三级医院专家门诊、专家查房、运用双向转诊及网络合作等医疗互助模式,重点了解公立医院与社区的多种医疗互助模式的效果。结果:在合作模式中,中医专家门诊的门诊量较西医专家门诊量大,通过三级医院的专家下社区,使我中心中医药服务能力有了很大提升。但住院患者与门诊患者的双向转诊比例失衡。结论 :公立医院专家至社区多点执业不仅可以使更多的社区居民节约时间和财力成本,增加居民对社区的支持和信任度,更能有效提升社区卫生服务中心的医疗服务能力。而双向转诊政策虽然实施多年,由于转诊通道不流畅,转诊细则不完善,使其更多地流于形式,转诊制度未能得到真正意义上的有效实施。

Objective： To survey the medical support and cooperation of the public hospital to Longhua Community Health Service Center to analyze the problems in the process of the cooperation and put forward the suggestion. Methods： The medical mutual aid mode of the expert outpatient service, expert rounds, and two-way referral network cooperation with the hospitals at the two and three levels that Longhua Community Health Service Center set up from June 2013 to May 2014 was summarized, which focused on the effect of the multiple medical assistance mode between the public hospital and the community. Results： In the cooperative mode, the outpatient volume of the traditional Chinese medicine was larger than that of the western medicine. The service ability of the community health service center was improved through a way that the experts went into the community from the tertiary hospitals. But the proportion of the referral between the inpatient and outpatient patients lost the balance. Conclusion： The public hospital experts to the community more places practice not only can save the time and cost of expense of the residents and increase the support and trust of the residents to the community health service center, but also more effectively improve the medical service ability of the center. The two-way referral policy has been carried out for some years, and due to the referral channel is not smooth, the referral rule is not perfect, which makes it a mere formality, and the system is unable to be effectively implemented in the real sense.