苏北地区分级诊疗实施效果分析

Effect analysis of grading diagnosis and treatment in northern Jiangsu province

目的通过对比江苏省苏北与苏南、苏中地区分级诊疗实施效果差异,分析影响实施效果的原因,从而为进一步优化分级诊疗制度提供依据。方法通过查阅文献、专家咨询等方法,研究分级诊疗效果评价指标,收集相关资料进行分析比较。结果苏北地区2015、2016年基层医疗卫生机构向上级医院转诊率分别为0.274%、0.190%,明显高于苏南和苏中地区;而上级医院向基层医院转诊率分别为0.264%、0.410%,明显低于苏南地区。结论苏北地区在分级诊疗实施过程中取得了一定效果,然而分级诊疗实施现状仍不容乐观,需进一步促进医疗资源下沉,提升基层医院医疗服务能力,制定双向转诊指南,优化转诊流程,提供政策保障,逐步完善“基层首诊、双向转诊、急慢分治、上下联动”的分级诊疗制度。

Objective By comparing the implementation effect of graded diagnosis and treatment in northern Jiangsu province with that in southern Jiangsu province and central Jiangsu province,the reasons affecting the implementation effect were analyzed,so as to provide a basis for further optimizing the graded diagnosis and treatment system. Methods Through literature review and expert consultation,the evaluation indexes of hierarchical diagnosis and treatment effect were studied,and relevant data were collected for analysis and comparison. Results In 2015 and 2016,the referral rate of primary hospitals to superior hospitals in northern Jiangsu was 0.274% and 0.190% respectively,which was significantly higher than that in southern Jiangsu and central Jiangsu.The referral rate from superior hospitals to primary hospitals was 0.264% and 0.410% respectively,which was significantly lower than that in southern Jiangsu. Conclusion Jiangsu province have obtained certain effect in the implementation of hierarchical diagnosis,grading diagnosis implementation present situation is not optimistic,however,need to further promote the supply of medical resources,improving the capacity of basic-level hospital medical service,to develop two-way referral guide,optimize the referral process,to provide policy guarantee,gradually improve the grading system of diagnosis and treatment with "the first option at the grass-roots level,two-way referral,slow partition,upper and lower linkage".