成都市某二级医院的双向转诊运行现状分析

Current Situation Analysis of the Two-way Referral Operation in a Second-class Hospital of Chengdu

目的分析某二甲医院双向转诊运行情况,为推动双向转诊提供一定参考。方法对某二甲医院近3年的双向转诊病历资料和医生双向转诊认知调查结果进行整理,通过对比分析,了解该院双向转诊的展开状况以及存在的问题。结果该院2015—2017年转诊率有所提高,转入与转出数目差距增大,完全按照分级诊疗指南执行的医生比例低;在医生调查中,上转与下转均存在阻碍,部分医生认为转诊影响业绩与绩效,病人的意愿和转诊通道不畅是影响转诊的最重要原因。结论要进一步推进双向转诊的运行,需要加强分级指南的落实,建立双向转诊配套政策和制度,加强双向转诊宣传,保证双向转诊的流畅性,同时二级医院要加强自身建设和医生队伍的建设,提升其在双向转诊中的中间节点作用。

Objective To analyze the current situation of the two-way referral operation in a second-class hospital so as to provide references for the further improvement of the two-way referral in China.Methods The medical records of the two-way referral between2015and2017and the survey Results of doctors'cognition about the two-way referral in a second-class hospital were collected and analyzed to investigate the development status and existing problems of the two-way referral in this hospital.Results The referral rate in this hospital had been increased to some extent from2105to2017,and the gap between the number of being referred in and out had also been increased.The proportion of doctors who strictly implemented the guidelines for grading diagnosis and treatment was low.According to the survey Results,there were obstacles in the upward and downward referrals,some doctors believed that the referral affected their performances and achievements,and the patients'willingness and poor access to the referral were the most important factors affecting the referral.Conclusion In order to further promote the two-way referral operation,it is necessary to strengthen the implementation of the guidelines for grading diagnosis and treatment,establish the supporting policies and systems for the two-way referral,enhance the publicity of the two-way referral,and ensure the fluency of the two-way referral.Meanwhile,the second-class hospital should improve the construction of the hospital and doctor team so as to promote the role as the intermediate node in the two-way referral.