社区慢性病管理过程中双向转诊的促进措施  

Promote Measures of the Two-way Referral in the Community Chronic Diseases Management

作　　者：李晓波[1] 顾健[1] 仇华[1] 朱晓花[1] 孙幸[1] 闪丹[2] 顾蔚[2] 王琰芳[1] 周峰 张为 

机构地区：[1]江苏省苏北人民医院扬州大学临床医学院,江苏扬州225001 [2]徐州医学院 [3]扬州市广陵区卫生局 [4]扬州市文峰社区

出　　处：《中国卫生事业管理》2013年第8期566-567,共2页Chinese Health Service Management

基　　金：江苏省科技厅重大科技支撑项目(编号:BE2009653);江苏省扬州市科技局重大科技支撑项目(编号:YZ2009061);江苏省卫生厅预防医学课题(编号:YZ201021)

摘　　要：目的:探索促进双向转诊的措施,完善社区慢性病的管理。方法:借助区域化卫生信息平台,由医院和社区医生组建慢性病管理团队,形成以院前、院中、院后医疗服务为中心环节的双向转诊。结果:初步在扬州市文峰社区卫生服务中心实施双向转诊。结论:双向转诊能促进区域卫生资源合理应用,健全社区慢性病管理机制。Objective To explore the measures to facilitate the two-way referral and improve the management of chronic dis- eases in community. Methods Based on the Regional Medical Information Platform, doctors from general hospital and community health service center make up Management Team responsible for the two-way referral which includes three key links： pre-hospi- tal,peri-hospital and post-hospital medical service. Results The two-way referral is preliminarily established between Wenfeng Community and Subei People＇s Hospital. Conclusion The two-way referral can distribute medical resources reasonably and improve the mechanism of chronic disea^a mnna^arn^nt

关 键 词：双向转诊 慢性病 社区 

分 类 号：R197.1[医药卫生—卫生事业管理]