完善定向转诊制度的思考

目的探讨完善定向转诊制度的思路。方法对某区开展定向转诊的情况进行分析。结果转诊要求的限制使病人得到的实惠不多；病人就医选择权过多，通过社区卫生服务中心定向转诊至上级医疗机构的病人并不多；定向转诊5种条件比较笼统缺乏可操作性，对于急症和重症病无明确规定；社区卫生服务中心医务人员的水平还需进一步提高。结论加大政策引导力度，促进居民慢性病首诊在社区；细化实施标准，增强定向转诊的操作性；加强培训考核，提高社区医师的业务水平；强化督查管理，保证定向转诊有序、规范地进行。

Reflection of perfection on rule of directional transfer

Objective To probe thinking on perfect rules of directional transfer. Method To analyse situation of directional transfer in a District. Results Limit of situation on requirement of transfer clinic makes patients to gain less really benefit, more rights of selection in seeking medical advice but less patients were transfered to higher level medical organizations, five conditions of directional transfer were rather general and without operative possibility, there is no clear and definite stipulation for severe and emergency patients, level of medical personnel in community health service were needed to be further improved. Conclusion To increase guiding force of policy, to promote residents suffered with chronic diseases taking first examination in community, to make more detail for standards, to enhance operative property of directional transter, to enhance training assessment, to further improve vocational level for community doctors, to strengthen supervision and management and to ensure directional transfer to be carried out orderly and standardized.