由双向转诊的实践看社区卫生服务与医疗中心的优势互补

2008年2月至7月，选择需要转诊的26例高血压患者，其中血压控制不佳20例（77％），3例为新发高血压，3例为继发性高血压。平均随访日22d（10～35d）。由社区的全科医生将患者的基本情况预先告知上级医院接诊医生，安排时间就诊，经过检查明确诊断或调整用药方案，血压控制稳定后转回社区。研究表明，通过转诊前双方医生的信息互通，接诊医生服务热情耐心，与患者的交流多一些，使患者感觉与自己挂号就诊有明显的不同，增加了转诊依从性；制定治疗方案时应尽量选择社区医院可以配给到的药物；上级医院如给予转诊患者更多的便利，双向转诊将能持续并不断完善。

A trial of two-way referral system between community health service and medical center

The trial of two-way referral enrolled 26 patients with hypertension, including 20 cases of refractory hypertension, 3 new cases and 3 cases of secondary hypertension, the average length of follow-up was 22 d (10-35 d). The family physicians in Huaihaizhong Road Community Health Service Center communicated with specialists in the medical center (Ruijin hospital), appointments were made and medical information and other materials were sent in advance. When investigations and adjustment of medication were made, and the blood pressure was under control, patients were referred back to the community. This two-way referral system promoted the information exchanges between two side, doctors got prior knowledge about patients' condition and would spend more time with the patients; and patients' feeling of satisfaction and compliance of the treatment were increased. From our experiences, we suggest that the therapeutic regime made by the medical center should be feasible to the community, and more convenience should be given to the referred patients, so that the effectiveness and efficiency of the two-way referral can be further improved.