上海市浦东新区区属公立医疗机构糖尿病双向转诊现况调查研究  

Bi-directional Referrals for Diabetes:a Survey in the Public Medical Institutions of Pudong New Area,Shanghai

作　　者：黄大志 丁以标 杜兆辉 HUANG Dazhi;DING Yibiao;DU Zhaohui(Pudong New Area Gaoqiao Community Health Center,Shanghai 200137,China;Pudong New Area Shanggang Community Health Center,Shanghai 200126,China)

机构地区：[1]上海市浦东新区高桥社区卫生服务中心,200137 [2]上海市浦东新区上钢社区卫生服务中心,200126

出　　处：《中国全科医学》2020年第36期4567-4572,共6页Chinese General Practice

基　　金：2017年上海市卫生计生系统优秀学科带头人培养计划(2017BR053);浦东新区卫生系统领先人才培养计划(PWRl2016-03);浦东新区卫生系统重要薄弱学科项目(PWZbr2017-07)。

摘　　要：背景糖尿病是一种复杂的慢性、终身性疾病,糖尿病的治疗是一项长期并需要随着病情进展不断调整的管理过程,而落实糖尿病双向转诊对于医疗卫生资源的合理利用以及减轻患者家庭及国家负担有极为重要的作用。目的调查上海市浦东新区区属公立医疗机构医务人员对糖尿病双向转诊的认知和满意情况,为完善浦东新区分级诊疗和医联体建设提供参考依据。方法2019年10月,以浦东新区区属所有公立医疗机构(7家二、三级医院和47家社区卫生服务中心)在职内分泌科医生和社区卫生服务中心全科医生为调查对象(n=621),采用自制调查问卷〔包括基本信息、对糖尿病患者双向转诊的了解情况(单选题)、对糖尿病患者双向转诊的相关原因和判定标准认识情况(多选题)、对糖尿病患者双向转诊的态度及满意度情况(单选题)〕进行调查,由调查对象通过问卷星自填完成。结果回收有效问卷590份,有效回收率为95.01%。调查对象对糖尿病双向转诊知晓率为82.88%(489/590);非常了解和比较了解糖尿病双向转诊制度的内容者占50.84%(300/590);非常了解和比较了解糖尿病双向转诊的标准者占54.92%(324/590);83.22%(491/590)的调查对象知道本单位有指定的双向转诊单位。不同职称调查对象对“是否了解糖尿病双向转诊制度”的选择情况比较,差异有统计学意义(P<0.05)。“糖尿病双向转诊中向上级医院转诊最常见的原因”问题中,84.92%(501/590)的调查对象选择“基层医疗卫生机构药品种类限制”;“糖尿病患者上转至上级医院的标准”问题中,35.59%(210/590)的调查对象选择“当患者首次在基层医疗卫生机构诊断为糖尿病(患者在基层医疗卫生机构诊断为糖尿病后是否需要转上级医院进一步分型和确定是否有并发症等情况)”;“糖尿病患者转回基层医疗卫生机构的标准”问题中,95.76%(565/590)的调查Background As diabetes is a complex lifelong chronic disease,treatment of diabetes is a long-term management that needs to be adjusted continuously according to the disease condition.The implementation of bi-directional referrals for diabetes plays an extremely important role in rationally utilizing medical resources and diminishing the burden of the family and the country.Objective To investigate the cognition and satisfaction regarding bi-directional referrals for diabetes among medical workers in public medical institutions in Pudong New Area,Shanghai,to provide a reference for improving hierarchical medical system and medical consortium development in this area.Methods In October 2019,participants(n=621) were recruited from public medical institutions in Pudong New Area,including endocrinologists from 7 secondary and tertiary medical institutions,and general practitioners(GPs) from 47 community health centers(CHCs).They were invited to complete an online survey conducted on www.wjx.cn platform using a self-administered questionnaire developed by our research group,covering demographic information,knowledge of bi-directional referrals for diabetes(single-choice questions),knowledge of causes and criteria of bi-directional referrals for diabetes(multiple choice questions),and attitudes and satisfaction regarding bi-directional referrals for diabetes(single-choice questions).Results The survey achieved a response rate of 95.01%(590/621).The prevalence of knowing bi-directional referrals for diabetes was 82.88%(489/590).The prevalence of knowing bi-directional referral system for diabetes well and very well was 50.84%(300/590).The prevalence of knowing criteria of bi-directional referrals for diabetes well and very well was 54.92%(324/590).The prevalence of knowing their hospital had a designated institution for referring diabetics bi-directionally was 83.22%(491/590).Professional title was associated with the difference in the choice of the answer to "Whether knowing bi-directional referral system for diabetes"(

关 键 词：糖尿病 双向转诊 分级诊疗 医疗机构 卫生保健改革 上海 

分 类 号：R587.1[医药卫生—内分泌]