慢性病病人在双向转诊中的下转现状研究

Study on current situation of downward referral in two-way referral for patients with chronic disease

目的:了解双向转诊中慢性病病人的下转现状及影响因素。方法:应用自行设计的“慢性病病人下转现状调查问卷”对成都市4所三级医院200例慢性病病人进行调查。结果:分别有11.5%、37.5%的病人有下转经历和愿意下转。病人不愿意下转的主要原因为基层医疗技术水平低。基层医疗机构首诊、已签约家庭医生、有下转经历、信任基层医疗技术对慢性病病人的下转意愿有影响(P<0.05)。结论:慢性病病人的下转率、下转意愿均较低。下转意愿受多种因素影响,应从宣传教育、政策完善、加强基层医疗服务建设等方面促进慢性病病人合理下转。

Objective:To investigate the current situation and influencing factors of downward referral among patients with chronic disease.Methods:The self-designed questionnaire was adopted to investigate 200 chronic disease patients from 4 tertiary hospitals in Chengdu.Results:A total of 11.5%and 37.5%patients had experienced downward referral and were willing to transfer downward respectively.The main reason why patients were not willing to transfer was the low level of primary medical technology.The status of the choice for first diagnosis and contracted family doctors,downward referral experience and trust in primary medical technology have an impact on downward referral willingness of chronic disease patients(P<0.05).Conclusions:Patients with chronic diseases had lower downward referral rate and downward referral willingness.The downward referral willingness was influenced by many factors,the rational downward referral of chronic disease patients should be promoted from the aspects of publicity and education,policy improvement,and strengthening the construction of primary medical services.