上海长宁区精神病患者双向转诊情况分析

目的寻找影响精神病患者双向转诊顺利实施中出现的问题，分析并提出解决的方法和途径。方法根据2008年1～6月我院门诊和出院患者数据，通过收集问卷与访谈结合的方法进行调查，分析转诊成功和未实现转诊的具体原因。结果2008年1～6月我区精神病患者自专科医院下转57名，占总出院人数的29％，自礼区卫生中心上转193名，占专科医院总门诊人数的1．72％。下转患者比例逐月下降。影响下转的主要因素为年龄不符合和患者及家属不理解而拒绝。结论双向转诊的顺利实施需要相关制度的保障。同时涉及到医院、社区和社会的各个方面，强调专科医院和社区卫生服务机构的重视和沟通、加强对社会、患者和家属的宣传教育都是促使双向转诊制度顺利运转的保障。

Analysis of the dual referral on mental patient in Changning District,Shanghai

Objective The paper is to study and analyze these problems in the process of dual referral of the mental patients in order to propose the ways to deal with them. Method Through investigating the data of the patients who visited the outpatient department and were hospitalized between Jan, -June 2008, collecting the questionnaire and interviewing the patients, the detail causes of successful or unsuccessful dual referral were analyzed. Results 57 mental patients were diverted from the mental special hospital to the community health centres, accounting for 29% in the discharged patients. 193 patients were transferred from the community health centres to the mental special hospital, accounting for 1.7% of the total outpatient visits from Jan to June 2008. The rate of referring mental patients to the community health centres went down. The key factors affecting dual referral from the mental special hospital to the community health centres were the patient＇s age which was not confirmed to referral and rejection by the patient＇s and their family＇s misunderstanding. ConciSion The dual referral coming alone well requires the insurance of the related rules and systems, meanwhile, involving the hospital, community, society and other fields. The communication between the hospitals and the community health centres should be emphasized. Education of society, patients and their families were also the insurance to accelerate the successful dual referral.