分级诊疗制度上海模式的政策效力

Policy Effect of Hierarchical Diagnosis and Treatment System in Shanghai

目的对上海市分级诊疗政策效果进行分析。方法结合已有的筛选策略和研究基础,运用SAS等软件对上海市2015年和2016年的医院服务数据库进行筛选,分析对比可下沉量的差距。结果在门诊下沉方面,2016年较2015年可下沉病人占比减少1.8%,尤其是高血压和糖尿病患者的门诊下沉量显著,降幅达16.5%;在康复和护理下沉方面,2016年较2015年可下沉病人占比分别减少0.5%和0.04%,可下沉住院日占比分别减少0.3%和0.9%。结论上海市分级诊疗政策初见成效,但分流下沉工作仍任重道远。

Objective To assess the effect of hierarchical diagnosis and treatment system in Shanghai. Methods Based on the existing screening methods and research basis, the hospital service database of 2015 and 2016 in Shanghai was analyzed through using software, such as SAS, to clarify differences between the number of referral patients in 2015 and 2016, and provide evidence for preliminary assessment of the effect of the policy. Results In 2016, the number of outpatients who could be subjected to referral is 1.8%, which is lower than that in 2015. Com- pared with 2015, the proportions of patients who could be referred to rehabilitation centers and nursing homes de- creased by 0.5% and 0.04% respectively, with the proportions of referral bed days decreased by 0.3% and 0.9% correspondingly. Conclusion Hierarchical diagnosis and treatment system in Shanghai has achieved initial results, however, there is still long way to go.