社区2型糖尿病患者转诊的模式的探讨.docVIP

社区2型糖尿病患者转诊的模式的探讨 　　摘 要 通过探讨家庭医生责任制模式下的双向转诊对社区2型糖尿病管理的交互作用，推广双向转诊，从而减轻综合性医院的医疗压力，合理分流患者，促进医疗卫生资源的优化配置。目前双向转诊运行不畅的重要原因仍以社区居民缺乏对社区卫生服务中心的认可及有效的监管机制为主。只有理顺上下级医疗机构的经济关系，明确各自职能，形成利益共同体，实现优势互补，并予以完善的社区服务医疗保险、收费制度等配套措施，加强设施、人员建设，才能真正实现“小病在社区，大病进医院”。 　　关键词 2型糖尿病 社区医疗机构 转诊管理 　　中图分类号：R587.1 文献标志码：A 文章编号：1006-1533（2016）14-0012-03 　　Discussion of the referral mode of type 2 diabetic patients in the community 　　ZHOU Rong1，2， HU Junfeng2， XU Min2， WU Caihua2， LIU Houjuan2（1. Geriatric Nursing Hospital of Huangpu District， Shanghai 200010， China； 2. Yuyuan Community Health Service 　　Center of Huangpu District， Shanghai 200010， China） 　　ABSTRACT Through discussing the interaction of two-way referral on the management of type 2 diabetes in the community under the family doctor responsibility system mode， the two-way referral is promoted to reduce the medical service pressure of general hospitals， reasonably shunt patients， and promote the optimized allocation of health resources. Currently， the important reason why two-way referral runs sluggishly is that community residents still lack the recognition of the community health service center and the effective supervision mechanism mainly. It can be truly realized that the slight illness is treated in the community， and the serious illness in the hospital by rationalizing the economic relations between the upper and lower medical institutions， defining their respective functions， forming a community of interests， realizing the complementary advantages， and improving the supporting measures of the medical and health insurance， charging system and so on and strengthening the construction of facilities and personnel. 　　KEY WORDS type 2 diabetes； community health service center； referral management 　　糖尿病（Diabetes mellitus，DM）是由遗传和环境因素相互作用所引起的一组代谢性疾病，基本特征是血中葡萄糖水平长期增高，可导致血管、心脏、神经、肾脏、眼等多组织器官损害。2013年我国糖尿病调查的流行病学资料显示，中国成年人中糖尿病患病率为11.6%，而糖尿病前期患病率则高达50.1%，其中大部分是2型糖尿病（T2DM）患者。然而在成人糖尿病患者中，知晓率仅为30.1%，治疗率仅为25.8%，血糖达标率仅为39.7%[1]。糖尿病现已成为继心血管疾