中国全科医学
中國全科醫學
중국전과의학
Chinese General Practice
2015年
29期
3537-3539
,共3页
臧国尧%方力争%陈丽英%朱文华%戴红蕾%陈建华%卢崇蓉%李利%晁冠群%张佳%乔巧华%黄丽娟%施秀阳
臧國堯%方力爭%陳麗英%硃文華%戴紅蕾%陳建華%盧崇蓉%李利%晁冠群%張佳%喬巧華%黃麗娟%施秀暘
장국요%방력쟁%진려영%주문화%대홍뢰%진건화%로숭용%리리%조관군%장가%교교화%황려연%시수양
病人转诊%全科医生%社区卫生服务
病人轉診%全科醫生%社區衛生服務
병인전진%전과의생%사구위생복무
Patient transfer%General practitioners%Community health services
目的：建立以全科医生医疗团队为基础的双向转诊模式。方法浙江大学医学院附属邵逸夫医院医务部门专门召集全科医学科、门诊办公室、急诊科、信息中心、住院部等相关科室召开双向转诊会议，形成《医院与基层医疗卫生机构双向转诊制度》；明确了双向转诊原则和双向转诊上转、下转指证；确定了上转下转转诊单内容；签订了双向转诊协议书，明确双方责任；明确双向转诊流程。结果通过全科医生培训，使得上下各级医院全科医生密切合作，形成以全科医生医疗团队为基础的双向转诊模式代替既往以医疗行政部门为主导地位的双向转诊模式，使全科医生融入患者临床诊治全过程。2012年1月—2013年12月从社区卫生服务中心或县市级医院全科医生转诊而来的患者共计168例，男66例，女102例；年龄15~94岁，平均年龄56岁。经过门诊或住院检查评估与治疗，患者均明确诊断，并确定治疗方案或转专科治疗，病情稳定后出院，并转诊至原来的社区卫生服务中心或县市级医院全科医生继续进一步治疗管理。结论初步建立了综合医院与基层医疗卫生机构双向转诊制度和以全科医生医疗团队为基础的双向转诊模式。
目的：建立以全科醫生醫療糰隊為基礎的雙嚮轉診模式。方法浙江大學醫學院附屬邵逸伕醫院醫務部門專門召集全科醫學科、門診辦公室、急診科、信息中心、住院部等相關科室召開雙嚮轉診會議，形成《醫院與基層醫療衛生機構雙嚮轉診製度》；明確瞭雙嚮轉診原則和雙嚮轉診上轉、下轉指證；確定瞭上轉下轉轉診單內容；籤訂瞭雙嚮轉診協議書，明確雙方責任；明確雙嚮轉診流程。結果通過全科醫生培訓，使得上下各級醫院全科醫生密切閤作，形成以全科醫生醫療糰隊為基礎的雙嚮轉診模式代替既往以醫療行政部門為主導地位的雙嚮轉診模式，使全科醫生融入患者臨床診治全過程。2012年1月—2013年12月從社區衛生服務中心或縣市級醫院全科醫生轉診而來的患者共計168例，男66例，女102例；年齡15~94歲，平均年齡56歲。經過門診或住院檢查評估與治療，患者均明確診斷，併確定治療方案或轉專科治療，病情穩定後齣院，併轉診至原來的社區衛生服務中心或縣市級醫院全科醫生繼續進一步治療管理。結論初步建立瞭綜閤醫院與基層醫療衛生機構雙嚮轉診製度和以全科醫生醫療糰隊為基礎的雙嚮轉診模式。
목적：건립이전과의생의료단대위기출적쌍향전진모식。방법절강대학의학원부속소일부의원의무부문전문소집전과의학과、문진판공실、급진과、신식중심、주원부등상관과실소개쌍향전진회의，형성《의원여기층의료위생궤구쌍향전진제도》；명학료쌍향전진원칙화쌍향전진상전、하전지증；학정료상전하전전진단내용；첨정료쌍향전진협의서，명학쌍방책임；명학쌍향전진류정。결과통과전과의생배훈，사득상하각급의원전과의생밀절합작，형성이전과의생의료단대위기출적쌍향전진모식대체기왕이의료행정부문위주도지위적쌍향전진모식，사전과의생융입환자림상진치전과정。2012년1월—2013년12월종사구위생복무중심혹현시급의원전과의생전진이래적환자공계168례，남66례，녀102례；년령15~94세，평균년령56세。경과문진혹주원검사평고여치료，환자균명학진단，병학정치료방안혹전전과치료，병정은정후출원，병전진지원래적사구위생복무중심혹현시급의원전과의생계속진일보치료관리。결론초보건립료종합의원여기층의료위생궤구쌍향전진제도화이전과의생의료단대위기출적쌍향전진모식。
Objective To establish a dual referral model based on the general practitioner medical team. Methods A number of meetings of dual referral were convened by the Department of General Practice,Sir Run Run Shaw Hospital,School of Medicine,Ahejiang University,with the participation of department of general medicine,outpatient office,emergency department,IT department,inpatient department and other relevant departments. Through these meetings,the system of dual referral between hospitals and medical settings at primary level was settled,the principles of dual referral and the indications for upward referral and downward referral were determined,the content of dual referral letter was designed,the contract of dual referral was signed with the responsibilities of both parties clarified,and the process of dual referral was settled. Results By the training of general practitioners,doctors and hospitals of all levels cooperate closely,forming a dual referral model based on the general practitioner medical team in replace of the previous dual referral mode in which medical administrative department took the leading role and integrating general practitioners into the entire process of clinical diagnosis and treatment of patients. From January 2012 to December 2013,168 patients were referred from community health service centers or county - level hospitals by general practitioners,including 66 males and 102 females,with an age range of 15 - 94 and an average age of 56. Through outpatient and inpatient examinations and treatment,all the patients were definitely diagnosed and were treated with certain therapies or referred to specialized treatment,after which all patients kept stable condition,discharged and referred back to original community medical settings or county - level hospitals to receive further treatment and management by general practitioners. Conclusion The system of dual referral between comprehensive hospitals and medical settings at primary level and the dual referral mode based on general practitioner team were preliminarily established.
