医务人员对双向转诊知信行情况的调查研究

目的：探讨深圳市观澜人民医院及属下社康中心医务人员对现行双向转诊的知一信-行情况，分析双向转诊制度实施初期的效果以及影响因素，进一步促进双向转诊工作的可持续性发展。方法：采用整群抽样方法．采用问卷调查方式了解深圳市宝安区观澜人民医院及属下的19家社康中心的467名医护人员。结果：在对现行双向转诊制度的认知中，有56．2％的医护人员知道双向转诊如何运转，相关分析显示：大年龄（r=0．238，P=0．000）、男性（r=-0．206，P=0．000）、高职称人员（r=0．172．P=0．000）、管理人员和医生（r=-0．274，P=0．000）、社康中心的医务人员（r=-0．325，P=0．000）、院级领导和科室负责人（r=-0．167，P=0．000）对现行双向转诊制度更为了解。对现行双向转诊效果的评价中，医务人员认为现行的双向转诊具有必要性、可行性、合理性、及时性和转诊通道畅通的分别有88．5％、94．3％、56．9％、95．5％和53．9％，有47．1％的医护人员认为现行的双向转诊总体效果较好。认为把病人从社康中心上转至观澜人民医院等上级医疗机构的最主要原因是需要专科治疗（占84．2％）和需要进一步诊治（占82．4％）；而下转的最主要原因是：患者是明确诊断后的常见病和多发病病人（占74．4％）和就诊方便（占43．8％）；转诊行为方面：在被调查的1个月时间段内，有142名社康中心医护人员（占70．0％）和161名医院医务人员（占73．6％）曾经接诊过转诊病人，两类单位医护人员曾接诊过转诊病人的比例无统计学差异（P〉0．05）。结论：观澜人民医院现行的双向转诊制度已取得初步成效，但医护人员对双向转诊的知信行情况仍有待进一步提高。

Investigation on the K-A-B of medical staff about two-way referral in Bao'an District of Shenzhen

Objective To investigate the knowledge, attitude and behavior （KAB） and advice of medical staff in Guanlan Hospital of Shenzhen about the two-way referral and to analyze their early effect. Method467 medical staff who worked in Guanlan Hospital and 19 community health service centers in Bao＇an district of Shenzhen were investigated about their KAB of two-way referral system with questionnaires. Results Among the respondents, 56. 2% had known the two-way referral well. Correlation analysis showed that the staff who tire older（r=0. 238,P=0. 000,male（r=-0. 206,P=0. 000） ,with higher titles（r= 0. 172,P=0. 000） ,managers or doctors（r=-0. 274,P=0. 000） ,working in health service center（r=- 0. 325,P= 0. 000）and the leaders sections （r=- 0. 167,P= 0. 000）had better understanding of two-way referral. 88. 5%, 94.3 %, 56.9 %, 95.5% and 53.90% agreed that two-way referral in this hospital was necessary, feasible, reasonable, timely and smooth for the two-way referral process, respectively. 47. 1% thought the overall effect for the two-way referral good. 84. 2% and 82. 4% thought that ＂need for specialist treatment＂ and ＂need for further diagnosis and treatment＂ were the main reasons for referral from community health service centers to specialist hospital. 74.4% and 43.8% thought that ＂common and frequently-- occurring disease patients＂ and ＂treatment convenience＂ were the main reasons for referral from specialist hospital to community health service centers. 142 （70.0%） health care workers in community health care centers and 161 health care workers （73. 6%） in Guanlan hospital had experience of receiving referral-patients during the surveyed one month. There were no statistical difference between them （P 〉 0. 05）. Conclusions The two-way referral achieves preliminary effects in this hospital, but the KAB of two-way referral for the health care workers are to be improved.