优化双向转诊模式以提升家庭医生签约服务能力——以首都医科大学附属复兴医院为例

Fuxing Hospital,Capital Medical University Optimizes the Bidirectional Referral Model to Improve the Service Capabilities of Family Doctors

我国实行家庭医生签约服务是新形势下实现全民健康的重要途径,目前处于探索阶段。双向转诊作为基层医院与三级综合医院上下联动的衔接,是家庭医生为签约居民提供连续性医疗服务的有力保障。目前我国双向转诊制度已经建立,虽取得一定成效,但仍存在很多问题。信息化的双向转诊模式,更加优化了双向转诊的流程,实现了医疗资源共享。因此应不断优化双向转诊制度,从而提高家庭医生签约服务能力,为签约居民提供高质量的连续性医疗服务,真正实现分级诊疗。本文以首都医科大学附属复兴医院(以下简称复兴医院)信息化双向转诊模式为例,对其效果进行分析。2015—2017年复兴医院双向转诊平台逐步趋于完善,完成5 400例患者双向转诊。3年内双向转诊人次有增加,但回转人次所占比例却未见明显增加,说明双向转诊平台还需要不断加以改进和完善,优化双向转诊模式于2018年1月开始实施,回转人次有一定增加。

Family doctor contractual service plays an important role in safeguarding the health of the Chinese people in the new era,which is in the exploratory stage.Bidirectional referrals connect the services delivered by the grassroots medical institution and tertiary general hospital,and provide strong support for family doctors offering continued care for contracted residents.Therefore,optimizing the bidirectional referral system can improve the service capabilities of the family doctor so as to provide high-quality continued care and enhance the development of hierarchical medical system.The implementation of bidirectional referral system in China faces many challenges,but has obtained some achievements,for example,the internetbased bidirectional referral model optimizes the bidirectional referral process and improves medical resources sharing.Fuxing Hospital,Capital Medical University uses the internet-based bidirectional referral model,and established an internet-based bidirectional referral platform.From 2015 to 2017,it provided bidirectional referral services for 5 400 patients via the platform being perfected while in use.Although the bidirectional referrals increased significantly in this period,the percentage of downward referrals increased unnotably,indicating that the platform needs further improvement.The latest optimized platform has been put into operation in January 2018,and the downward referrals implemented via it show a fair growth.