基于家庭医生111签约分级诊疗实践与思考.docVIP

基于家庭医生111签约分级诊疗实践与思考 　　摘 要 目的：探讨社区基于家庭医生“1+1+1”签约的分级诊疗体系的实施情况。方法：选取2016年在本中心通过医联预约挂号平台“95169”和家庭医生综合管理平台“1+1+1”转诊至综合性医院门诊就诊的患者为研究对象，收集和分析就诊患者的基本情况、就诊情况及疾病情况。结果：2016年通过家庭医生综合管理平台“1+1+1”转诊的患者共300人次，通过医联预约挂号平台“95169”转诊的患者共438人次。转诊患者以60岁以上人群为主，就诊科室主要集中在消化科、眼科、神经内科、内分泌科、心血管科和骨科。老年患者转诊原因为慢性病配药的占比较高，为47.15%，结论：构建分级诊疗体系还需寻求更多的需求支持、政策支持和信息技术支持。 　　关键词 家庭医生；“1+1+1“签约；分级诊疗 　　中图分类号：R197.1 文献标志码：A 文章编号：1006-1533（2018）02-0014-04 　　Practices and thoughts of the hierarchical diagnosis and treatment based on ‘1+1+1’contract of family doctors 　　TAN Linglin1， TANG Chunhong2， ZHANG Jianmei3， LI Manwen3， ZHUANG Jianlin4（1.Longbai Community Health Service Center of Minhang District， Shanghai 201105， China； 2.Gumei Community Health service Center of Minhang District， Shanghai 201102， China； 3.Family Doctor Service Center of Longbai Community Health Service Center of Minhang District， Shanghai 201105， China； 4.Genreral Office of Changning District Center for Disease Control and Prevention， Shanghai 200336， 　　China） 　　ABSTRACT Objective： To discuss the implementation of the hierarchical medical system based on the ‘1+1+1’ contract of family doctors in a community. Methods： In 2016， the patients who were transferred from the community health service centers to the outpatient clinics of the general hospitals through the ‘95169’ medical association appointment platform and the‘1+1+1’ family doctor comprehensive management platform were selected as the research objects. The basic situation， medical conditions and disease situation of the patients were collected and analyzed. Results： In 2016， a total of 300 person times were transferred through the “1+1+1” family doctor comprehensive management platform， and a total of 438 person times were transferred through the “95169” medical association appointment registration platform. The transferred patients were mainly over 60 years old. The departments of medical treatment mainly concentrated in the departments of gastroenterology， ophthalmolo