【摘要】 目的分析某县级医院双向转诊情况,探索县级医院在县域医共体分级诊疗中的定位与发展。方法选取2016年1月1日-2018年12月31日某院双向转诊患者为研究对象。收集并回顾性分析就诊患者的信息,包括患者的基本信息、疾病诊断、就诊日期、就诊科室等。结果实际有效双向转诊患者共4724人次,其中男2761人次,占58.4%,女1963人次,占41.6%。年龄52.6±23.6岁(0岁～106岁),其中50岁以上2867人次,占60.7%,60岁以上2090人次,占44.2%。上转患者就诊的前5位疾病为外伤1096人次,占23.3%;脑血管病632人次,占13.4%;骨折338人次,占7.2%;临产328人次,占7.0%;慢阻肺210人次,占4.5%。下转患者就诊的疾病为恶性肿瘤8人次,占47.1%;结核7人次,占41.2%;肝炎2人次,占11.8%。转诊机构为卫生院4198人次,占89.0%;中医院401人次,占8.5%;卫生站109人次,占2.3%;慢病站8人次,占0.2%。上转患者就诊季节主要集中在冬季,上转百分比增加。其中外伤、脑血管和骨折最为明显,而慢阻肺春季上转占比最高。结论县级医院双向转诊疾病谱多为急症或慢性病,卫生院是最主要转诊机构。医政部门应加强政策引导与管理,提高基层卫生服务机构的诊疗水平,增加下转比例,充分发挥县级医院在分级诊疗中的作用。更多还原

【Abstract】 Objective By analyzing the situation of two-way referral in county hospitals,this study aimed to explore the orientation and development of county hospitals in the graded diagnosis and treatment of county medical community.Methods The two-way referral patients in Yangshan People’s Hospital from January 1 st,2016 to December 31 st,2018 were selected as the objects.We collected and retrospectively analyzed the patients’ information,including the basic information,diagnosis,consulting date and department,etc.Results From January 1 st,2016 to December 31 st,2018,the actual effective two-way referral patients in Yangshan County People’s Hospital were 4724 person-times,including 2761 males(58.4%) and 1963 females(41.6%),aged 52.6±23.6 years(0-106 years old).Among them,2867 person-times who were over50 years old(60.7%),2090 person-times who were over 60 years old(44.2%);the top five diseases of the highest number of referral patients were trauma(1096,23.3%),cerebrovascular disease(632,13.4%),fracture(338,7.2%),labor(328,7.0%),chronic obstructive pulmonary disease(210,4.5%).The top three diseases of the highest number of refer patients were tumor(8 persons,47.1%),tuberculosis(7,41.2%),and hepatitis(2,11.8%).The referral agencies were(4198,89.0%) in health centers,(401,8.5%) in Chinese medicine hospitals(109,2.3%) in health stations,and(8,0.2%) in chronic diseases stations.The attendance season of patients who were transferred is mainly concentrated in winter,and the percentage of transfer increases.Among them,trauma,cerebrovascular and fracture were the most obvious.COPD occupied the highest proportion in spring.Conclusions The disease spectrum of bi-directional referral in county hospitals was acute or chronic diseases.Township hospital was the main referral institution.Medical administration department should strengthen policy guidance and management,improve the ability of diagnosis and treatment for health service institutions,increase the proportion of downward transfers,which would help to play the role of county hospitals in graded diagnosis and treatment.更多还原