重庆市医联体内分级诊疗效果研究——以糖尿病诊疗为例

Study on the Effect of Grading Diagnosis and Treatment in Chongqing Medical Association——Taking Diabetes Diagnosis and Treatment as An Example

目的:评价重庆市医联体内分级诊疗实施效果,为完善分级诊疗、医联体建设提供政策参考。方法:以糖尿病患者为调查对象,分析2015—2017年重庆市4家医联体内核心医院和成员医院的医疗服务量、双向转诊量、上下联动、医患主观感知等情况。结果:医联体内分级诊疗初显成效,医疗费用增长有效控制,但是"看病难"问题依然突出,单向转诊现象依然存在。结论:明确医联体内各级机构功能定位,切实推动医联体内分级诊疗的实施。

Objective To evaluate the implementation effect of grading diagnosis and treatment in Chongqing Medical Association,and provide policy reference for improving grading diagnosis and treatment and medical association construction.Methods Taking diabetes patients as the survey object,the medical service volume,two-way referral volume,up-and-down linkage,and subjective perception of doctors and patients were analyzed in the core hospitals and member hospitals of four medical associations in Chongqing from 2015 to2017.Results The medical treatment in the medical union showed initial effects,and the medical expenses increases was controlled effectively.The problem of'difficult to see a doctor'is still outstanding,and one-way referral still exists.Conclusion We should clarify the functional positioning of various institutions in the medical association,and effectively promote the implementation of grading diagnosis and treatment in the medical association.