重庆市某医联体医患双方对双向转诊认知的调查研究  

Research on Two-way Referral Cognition of Doctors and Patients in Medical Treatment Partnership System in Chongqing

作　　者：罗昭旸 刘利[1] LUO Zhaoyang;LIU Li(School of Public Health and Management,Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学公共卫生与管理学院,重庆市400016

出　　处：《中国全科医学》2020年第12期1535-1540,共6页Chinese General Practice

基　　金：重庆市决策咨询与管理创新计划重点项目(csts2016jccxBX0022)。

摘　　要：背景医疗联合体(以下简称医联体)模式是促进医疗资源合理分配、完善分级诊疗的有效途径之一。截至2018年,重庆市已经实现医联体模式全面覆盖,重庆医科大学附属第一医院医联体于2011年3月成立,经过6年多的发展,医联体取得一定成效。本研究选择该医联体为样本,研究医疗体内医患双方对双向转诊的运行情况,为完善重庆市分级诊疗格局提供政策参考。目的调研重庆市某医联体医患双方对双向转诊的认知现状、双向转诊中存在的问题,探讨问题解决方案。方法2017年9—11月和2017年8—10月,采用随机抽样调查分别对重庆医科大学附属第一医院医联体内共6家医疗机构的医务人员和住院患者进行问卷调查。自行设计调查问卷,问卷内容包括医务人员及患者基本信息、对双向转诊的知晓情况,医务人员双向转诊开展情况及相关因素、患者双向转诊及影响因素,医患双方对双向转诊顺畅的认可情况及对双向转诊实施的认可情况。结果医务人员有效问卷应答率为88.3%(309/350)。288例(93.2%)医务人员对双向转诊知晓。不同职称、来源医院医务人员对双向转诊知晓情况比较,差异有统计学意义(P<0.05)。在工作中有过为患者提供转诊服务经历的医务人员282例(91.3%)。有过为患者提供转诊服务经历的医务人员中双向转诊者151例(53.5%),向上转诊诊者62例(22.0%),向下转诊者69例(24.5%)。核心医院医务人员向下转诊患者时考虑因素主要是病情已稳定,处于康复期或恢复期;托管区县医院医务人员向上转诊患者时考虑因素主要是患者病情需要。阻碍核心医院医务人员向下转诊的因素主要是患者对基层医疗技术水平不满意。阻碍托管区县医院医务人员向下转诊的因素主要是下级医院能力不足。核心医院、托管区县医院医务人员对双向转诊顺畅的认可率比较,差异无统计学意义(χ^2=0.090Background The medical treatment partnership system is one of the effective ways to promote rational distribution of medical resources and improve hierarchical diagnosis and treatment.As of 2018,Chongqing has achieved comprehensive coverage of the medical treatment partnership system.The medical treatment alliance of the First Affiliated Hospital of Chongqing Medical University was established in March 2011 and has achieved some progress over the past six years.This paper takes the medical treatment partnership system as a sample to study the operation of two-way referral among doctors and patients in the system,so as to provide policy reference for improving the hierarchical diagnosis and treatment pattern in Chongqing.Objective To investigate the cognitive status of two-way referral,the problems existing in two-way referral,and to explore its solutions.Methods From September to November 2017 and from August to October 2017,a random sampling survey was used to investigate the medical staff and inpatients of six medical institutions in the medical treatment partnership system of First Affiliated Hospital of Chongqing Medical University.Self-designed questionnaire included topics such as basic information of medical staff and patients,knowledge of two-way referral,implementation of two-way referral by medical staff and relevant factors,two-way referral of patients and influencing factors,reorganization of smooth two-way referral and the implementation of two-way referral among medical staff and the authors.Results The response rate of questionnaire among health care providers was 88.3%(309/350).A total of 288(93.2%)health care professionals were aware of the two-way referral.The medical staff with different professional titles and source hospitals had significant difference in knowing the two-way referral(P<0.05).There were 282(91.3%)health care professionals who had provided referral services to patients during their work;among them,there were 151(53.5%)two-way referrals,62(22.0%)were upward referral visits,and 6

关 键 词：医联体 双向转诊 认知 研究 重庆 

分 类 号：R197.3[医药卫生—卫生事业管理]