2型糖尿病“全科-专科”分级诊疗协作管理模式及开展现状研究  

Theory and Implementation of General-specialty Hierarchical Management Mode for Type 2 Diabetes

作　　者：戴慧敏[1] 刘伟[2] 吴培红[2] 朱敏[1] 陈瑜[1] 杜兆辉 DAI Hui-min;LIU Wei;WU Pei-hong;ZHU Min;CHEN Yu;DU Zhao-hui(Weifang Community Health Service Center,Shanghai 200122,China;Department of Endocrinology,Renji Hospital Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海市浦东新区潍坊社区卫生服务中心,200122 [2]上海交通大学医学院附属仁济医院内分泌科,上海市200127

出　　处：《中国全科医学》2018年第10期1188-1192,共5页Chinese General Practice

基　　金：上海市浦东新区卫生系统优秀青年医学人才项目(PWRq2016-21);上海市卫生与计划生育委员会面上项目(201440471);浦东新区科技发展基金项目(PKJ2015-Y62)

摘　　要：基于上海市"1+1+1"签约分级诊疗模式,潍坊社区卫生服务中心与上海交通大学医学院附属仁济医院协同合作,以2型糖尿病为突破口,建立了2型糖尿病"全科-专科"分级诊疗协作管理模式。该模式以设立在社区卫生服务中心的"仁济-潍坊"糖尿病专病工作室为载体,明确了糖尿病的分级诊疗标准和转诊流程,并要求药品配置和实验室检查同质,本文主要介绍其开展模式和实施效果。通过"全科-专科"共同管理,能够合理兼顾各级医疗机构的利益,同时提高了社区卫生服务中心的医疗能力和水平,有助于为患者提供优质、高效、便捷、连续的医疗服务。Based on the"1+1+1"hierarchical contractual service delivery mode implemented in Shanghai,Weifang Community Health Service Center(WCHSC)and Renji Hospital Shanghai Jiaotong University School of Medicine(RHSJUSM)developed a general-specialty hierarchical management mode for type 2 diabetes.This mode of care is co-delivered by both WCHSC(offering primary care)and RHSJUSM(offering specialty care)in Renji-Weifang Diabetes Studio in WCHSC,using the co-developed hierarchical diagnosis and treatment criteria and referral procedure for diabetes,under the conditions of sharing anti-diabetic drugs,as well as diabetes-related laboratory findings.We introduced both the theory and implementation of general-specialty hierarchical management mode for type 2 diabetes in detail,proposed that by using this mode,the interests of both primary and tertiary medical institutions can be achieved reasonably,the service capabilities and level of the community health service center can be improved,and diabetic patients can get easier access to high-quality,high-efficient and continued care.

关 键 词：分级诊疗 家庭医生签约服务 糖尿病 2型 

分 类 号：R197[医药卫生—卫生事业管理] R587.1[医药卫生—公共卫生与预防医学]