医患行为对我国农村乡县跨级住院服务整合的影响  

What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission in Rural China

作　　者：张研[1,2] 卢珊[1,2] 张亮[1,2] 

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030 [2]湖北省人文社科重点研究基地农村健康服务研究中心,湖北武汉430030

出　　处：《中国医院管理》2016年第4期21-24,共4页Chinese Hospital Management

基　　金：国家自然科学基金资助项目(71273099);中国博士后科学基金面上项目(2015M582231)

摘　　要：我国农村地区乡县跨级住院服务整合中存在患者病历信息传递困难、县级医生乡镇信息利用程度不高的问题,其原因在于患者缺乏信息传递意识、对乡镇医疗水平不信任、乡镇卫生院医生叮嘱患者携带信息意识不强、县级医院医生利用乡镇信息主动性缺乏并存在对立风险等。医生行为对跨级服务整合的影响体现在能力和合作行为上,而患者自由就医的行为则不利于医患沟通的稳定与医疗机构分工协作。乡县跨级住院服务的整合需要强化医生的整合服务意识以及患者的合理就医与信息传递意识,推动不同层级医疗机构间整合政策的制定需要关注保障机制和约束机制,同时通过量化核算衡量利弊决定县域信息系统的建立。There are several problems in service integration of multi-institutional readmission in rural China. For example,it is difficult for patients to transfer inpatient treatment information during readmission between township hospitals and county hospitals, and the utilization of previous treatment is inadequate. All of these problems results from Patients＇ lacking of conscious awareness of information transfer,not believing in the treatment of county hospitals,doctors＇ lacking awareness of urging information transfer and utilizing information, etc. The impact of doctor behavior on service integration of multi-institutional readmission reflects on ability and cooperation, while the disordered hospitalization choices of patients have no benefit on information transfer and duty division. In conclusion,service integration of multi-institutional readmission needs to strengthen the willingness of cooperation among doctors and the awareness of information transfer among patients. Relevant policy making should pay more attention to security and restraint mechanism. At the same time, the information system need to be constructed after considerably weighing the pros and cons.

关 键 词：跨级住院 再入院 信息传递 医生行为 连续性 农村 

分 类 号：R197.3[医药卫生—卫生事业管理]