可分流长期护理机构的住院病人筛选方法与实证研究

Screening Methods and Empirical Study on Inpatients Who Can be Referred to Nursing Home

目的准确测算大型医院住院患者可下沉至护理机构的数量,为合理推进分级诊疗和基层卫生资源配置提供科学性依据。方法结合前期研究成果和专家咨询,基于住院日、病种和转归情况,建立住院病人下沉的筛选方法,并计算可下沉的住院日。结果样本城市2016年可下沉的护理机构的病人为5 775人次,总住院日为51.6万天。结论为推进住院病人下沉,建议引入评估机制完善病人转诊规则,针对下沉病人的高发病种,加强基层卫生机构相应的资源配置。同时借助长期护理保险实施,进一步促进护理病人的下沉。

Objective To accurately measure the potential number of inpatients who can be referred to nursing home in order to provide a scientific basis for promotion of tiered medical service system. Methods Based on preliminary research and expert consultation, establishing screening methods for inpatients that could be subjected to referral according to hospitalization days, entities and prognosis situation. Results The number of patients who could be referred was 5775 in 2016, and the total bed days were 516 thousand. Conclusion In order to promote the referral of inpatients, it is suggested that an evaluation mechanism be introduced to improve referral rules. Corresponding resource allocation in primary medical institutions should be strengthened in terms of diseases of high incidence for patients who have been referred. At the same time, implementation of long-term care insurance will further promote the referral of nursing patients.