海军部队医疗机构双向转诊情况调查
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摘要
目的了解海军某片区部队医院与基层医疗机构间双向转诊情况。方法选取9个部队900名官兵、4所基层医疗机构24名医务人员和2所医院35名科室负责人,对就医顺畅程度、就医行为,医疗机构水平和医疗服务体系构建模式进行问卷调查和访谈。结果 78.2%的医务人员认为就医流程较为顺畅,71.8%的官兵选择基层医疗机构首诊,基层医疗机构与医院水平差距较大,58.2%的医务人员认为从体制上融合基层医疗机构和医院是最有效的医疗服务体系。结论转上容易转下难较为普遍,需要从构建医疗一体化保障模式、加强制度建设与宣传、建强基层医疗机构和完善考核力度等方面予以完善。
Objective To explore dual referral between naval primary medical institutions and hospitals.Methods 900 service men from 9 units,24 military surgeons from 4 primary medical institutions and 35 military surgeons from 2 hospitals were investigated into smoothness of process for medical service,medical seeking behavior,medical and technical level of primary medical institutions and hospitals,and structuring of medical service system. Results 78. 2% of all medical surgeries believe that process for medical service is smooth and 58. 2% of them believe that system integration of primary medical institution and hospital is the most effective medical service system,71. 8% of serviceman would choose primary medical institution for first diagnosis,medical and technical level of primary medical institution and hospital has a great distance. Conclusion Upward referral is common but downward referral is difficult. Efforts should be made to establish the integration mode of medical service,strengthen dual referral system construction and publication,improve ability of primary medical institutions and perfect examination system of dual referral.
Objective To explore dual referral between naval primary medical institutions and hospitals.Methods 900 service men from 9 units,24 military surgeons from 4 primary medical institutions and 35 military surgeons from 2 hospitals were investigated into smoothness of process for medical service,medical seeking behavior,medical and technical level of primary medical institutions and hospitals,and structuring of medical service system. Results 78. 2% of all medical surgeries believe that process for medical service is smooth and 58. 2% of them believe that system integration of primary medical institution and hospital is the most effective medical service system,71. 8% of serviceman would choose primary medical institution for first diagnosis,medical and technical level of primary medical institution and hospital has a great distance. Conclusion Upward referral is common but downward referral is difficult. Efforts should be made to establish the integration mode of medical service,strengthen dual referral system construction and publication,improve ability of primary medical institutions and perfect examination system of dual referral.
引文
[1]刘晓溪,陈玉文,毕开顺.借鉴英国医疗服务体系破解我国实施双向转诊制度难题[J].中国全科医学,2013,16(9):2926-2929.
[2]杨立成,鲍琳辉,田义娟,等.医联体模式下构建双向转诊机制的探讨[J].中国医院,2015,19(7):33-35.
[3]李跃平,吴涵梅.医疗保障制度的建立与完善双向转诊制度实施的影响研究[J].中国全科医学,2011,14(2):367.
[4]王倩云,鱼敏,梁君蓉.国外双向转诊制度对我军基层卫生服务工作的启示[J].解放军医院管理杂志,2007,14(1):20-21.
[5]周辉,宁资社.从体系收治看基层医疗机构过度后送问题[J].解放军医院管理杂志,2000,7(5):333-334.
[6]唐洪钦,欧崇阳,谢勇,等.海军基层军医素质构成与规范化培训需求调查研究[J].海军医学杂志,2015,36(1):54-56.
[7]张宝,孙金海,刘文宝,等.一体化卫勤保障模式下基层卫勤的转型对策研究[J].人民军医,2016,59(10):1070-1072.
[8]帅力,许苹,段增杰,等.国内外医疗联合体发展对卫勤一体化保障的启示[J].解放军医院管理杂志,2016,23(11):1095-1097.
[9]高阔,甘筱青.我国患者双向转诊行为决策及影响因素研究[J].中国全科医学,2015,18(28):3393-3395.
[10]杨明,陈勇,罗克品,等.军事训练伤一体化双向转诊探索[J].解放军医院管理杂志,2015,22(12):1124-1125.
[11]邵志民,田晓洁,罗力.上海市老年患者就医流向和引导方法研究[J].中华医院管理杂志,2014,30(10):791-794.
[12]王梦媛,颜建周,张伶俐,等.美国节余分享计划下的责任医疗组织制度研究[J].卫生经济研究,2017,33(1):53-57.
[2]杨立成,鲍琳辉,田义娟,等.医联体模式下构建双向转诊机制的探讨[J].中国医院,2015,19(7):33-35.
[3]李跃平,吴涵梅.医疗保障制度的建立与完善双向转诊制度实施的影响研究[J].中国全科医学,2011,14(2):367.
[4]王倩云,鱼敏,梁君蓉.国外双向转诊制度对我军基层卫生服务工作的启示[J].解放军医院管理杂志,2007,14(1):20-21.
[5]周辉,宁资社.从体系收治看基层医疗机构过度后送问题[J].解放军医院管理杂志,2000,7(5):333-334.
[6]唐洪钦,欧崇阳,谢勇,等.海军基层军医素质构成与规范化培训需求调查研究[J].海军医学杂志,2015,36(1):54-56.
[7]张宝,孙金海,刘文宝,等.一体化卫勤保障模式下基层卫勤的转型对策研究[J].人民军医,2016,59(10):1070-1072.
[8]帅力,许苹,段增杰,等.国内外医疗联合体发展对卫勤一体化保障的启示[J].解放军医院管理杂志,2016,23(11):1095-1097.
[9]高阔,甘筱青.我国患者双向转诊行为决策及影响因素研究[J].中国全科医学,2015,18(28):3393-3395.
[10]杨明,陈勇,罗克品,等.军事训练伤一体化双向转诊探索[J].解放军医院管理杂志,2015,22(12):1124-1125.
[11]邵志民,田晓洁,罗力.上海市老年患者就医流向和引导方法研究[J].中华医院管理杂志,2014,30(10):791-794.
[12]王梦媛,颜建周,张伶俐,等.美国节余分享计划下的责任医疗组织制度研究[J].卫生经济研究,2017,33(1):53-57.