某三甲医院医师及患者转诊认知现况研究

Discussion on the awareness of dual referral between patients and doctors

目的:了解医师及患者对转诊的认知情况,分析现有问题,为完善医联体转诊制度提供参考。方法:文献研究与专家访谈相结合,形成调查问卷;对北京市某三甲医院重点转诊科室医师及患者共573人进行问卷调查。结果:患者偏向大型医院首诊,对医疗服务、医疗机构、医联体认知高的患者易转诊;社区卫生服务中心缺乏药品、医疗水平低、患者对基层医师不信任、转诊流程和权责不明晰是转诊的主要障碍;不同科室、不同收入的医师对转诊的认知程度不同;医师认为患者转诊需求被抑制。结论:合理配置医疗资源,强化社区投入,加强医联体建设,完善转诊制度,畅通医方沟通渠道,加强舆论引导,对促使患者合理就医有积极作用。

Objectives：To understand the awareness of dual referral of patients and doctors, analyze its problems and give references on building dual referral system between the members of hospital group. Methods：573 patients and doctors in a top tertiary hospital in Beijing were selected to have a questionnaire based on literature review and Delphi. Results：Patients prefer to large hospital for the first visiting. Patients who have better awareness on healthcare, healthcare institute and hospital group get better dual referral. Main factors influencing dual referral include lack of drug in primary healthcare institute, low trust and low capacity of primary healthcare institute and ambiguous process and responsibilities. There are big gaps on the awareness of dual referral between departments. Doctor thinks that the demands of patient dual referral has been reduced. Conclusions：The active factors on promoting rational visiting include rational health resources allocation, increasing investment on primary healthcare institute, strengthening hospital group, completing dual referral system, improving hospital patient communication and strengthening public propaganda.