双向转诊的困境与对策

The Problems and Countermeasures of Two-way Referral

为探究双向转诊的规范化管理,构建畅通的双向诊疗体系。分析了转诊患者病案管理基本要求,调查发现双向转诊缺少监管考核机制;因患者诊疗信息共享不畅,以致延误最佳治疗时机;患者转诊认识不足,具有抵触情绪;基层医院医疗水平差,高水平专技人才匮乏等诸多问题。为此,提出了利用医保差别化支付的激励机制,合理引导就医流向;构建区域卫生信息平台,实现患者转诊信息共享;规范医疗机构间转接诊管理,构建便捷畅通的双向转诊机制;通过薪酬制度改革,调动医务人员服务基层的积极性;大力宣传社区卫生服务,引导社区居民树立科学的就医理念;开展对口帮扶,提高基层医疗机构医疗质量、服务水平和业务能力;稳步推进“互联网+医疗健康”建设,加强信息化技术在转诊中的应用,将病案质量和双向转诊纳入监管考核机制等措施。总之,双向转诊和转诊患者病案信息管理涉及面广,需要政府和医院等多方共同努力,同时利用现代信息化技术,实现创新发展。

In order to explore the standardized management of two-way referral,establish a smooth two-way diagnosis and treatment system.Based on the analysis of the basic requirements of the medical record management of the referred patients,the investigation found that the two-way referral lack of supervision and assessment mechanism;The optimal treatment time is delayed due to poor sharing of patient diagnosis and treatment information;Lack of patient referral awareness and resistance;The medical level of primary hospitals is poor,the shortage of high-level technical personnel and many other problems.Therefore,the incentive mechanism of differentiated medical insurance payment is put forward to guide the flow of medical treatment rationally.To build a regional health information platform to share patient referral information;Standardize the management of referral between medical institutions,and build a convenient two-way referral mechanism;Through the reform of salary system,mobilize the enthusiasm of medical personnel to serve the grassroots;To promote community health services and guide community residents to establish a scientific concept of medical treatment;Carry out matching assistance to improve the medical quality,service level and professional capacity of community-level medical institutions;We will steadily promote the construction of"Internet plus medical and health care",strengthen the application of information technology in medical referrals,and incorporate the quality of medical records and two-way referrals into the supervision and assessment mechanism.In short,the information management of two-way referral and referred patient's medical record involves a wide range of areas,which requires the joint efforts of the government,hospitals and other parties,and the use of modern information technology to achieve innovative development.