不同级别医务人员对双向转诊的态度和实施现状研究  

Attitudes and current implementation of bidirectional referral among medical staff at different levels

作　　者：侯新宇 赵宁 顾梅 杨佳 HOU Xinyu;ZHAO Ning;GU Mei;YANG Jia(School of Public Health,Capital Medical University,Beijing,100069,PRC)

机构地区：[1]首都医科大学公共卫生学院,北京市100069

出　　处：《中国医院》2024年第11期64-68,共5页Chinese Hospitals

基　　金：国家自然科学基金青年项目(71603175)。

摘　　要：目的:了解实施双向转诊后,样本地区不同级别医务人员对双向转诊的态度和双向转诊实施现状,为推进双向转诊的落实、完善分级诊疗政策提供决策参考。方法:采用分层抽样方法,选择北京、福建、青海3个省/市共900名医务人员进行问卷调查。结果:样本地区医务人员对双向转诊的了解程度为81.89%;64.67%的基层医务人员上转过患者,61.67%的人接诊过下转患者;43.89%的二、三级医务人员下转过患者,47.22%的人接诊过上转患者。实施双向转诊政策后,均有80%以上的医务人员认为专业技术能力有所提升,收入及待遇和工作量有所增加。结论:医务人员对双向转诊政策的了解程度高,基层医务人员转诊患者情况优于二、三级医院医务人员,但总体转诊患者数量均偏少。为此,可通过加强政策宣传、均衡布局基层卫生资源、根据患者需求提供个性化服务等方式提高对患者在基层主动就医行为;探索双向转诊资源和利益共享机制,提高医务人员的转诊动力。通过多举并施,有序推进基层首诊和双向转诊。Objective:To understand the attitudes of medical staff at different levels toward bidirectional referral after its implementation and to assess the current status of its implementation in sample regions,providing decision-making references for promoting bidirectional referral and improving hierarchical medical system policies.Methods:A stratified sampling method was used to select 900 medical staff from Beijing,Fujian,and Qinghai provinces/municipalities for a questionnaire survey.Results:The level of awareness of bidirectional referral among medical staff in the sample regions was 81.89%;64.67%of primary-level medical staff had referred patients upward,and 61.67%had received patients referred downward;43.89%of secondary and tertiary-level medical staff had referred patients downward,and 47.22%had received patients referred upward.After the implementation of the bidirectional referral policy,over 80%of medical staff reported improvements in professional skills,with increases in income,benefits,and workload.Conclusion:Medical staff have a high level of awareness of the bidirectional referral policy,with primary-level staff being more active in patient referral compared to staff in secondary and tertiary hospitals,although the overall number of referrals remains low.To address this,strategies such as enhancing policy promotion,balancing the distribution of primary healthcare resources,and offering personalized services based on patient needs can encourage patients to seek care at the primary level.Additionally,exploring mechanisms for resource and benefit sharing in bidirectional referral can increase the motivation of medical staff for referrals.By taking these measures,the orderly progression of primary-level first diagnosis and bidirectional referral can be promoted.

关 键 词：双向转诊 基层首诊 医务人员 分级诊疗 

分 类 号：R197[医药卫生—卫生事业管理]