以区慢病防治院为桥梁构建深圳市福田区分级诊疗体系

目的 探索以区慢性病防治院为桥梁,构建具有深圳福田特色的分级诊疗体系,并初步评价其实施效果。 方法 通过建立区域性医联体、出台分级诊疗实施方案、确立区慢性病防治院的桥梁作用,负责分级诊疗的协调、培训和全过程的质量控制;成立学科联盟、提升基层医疗服务能力、完善双向转诊服务流程和区域医疗协同机制、加快分级诊疗信息化建设等系列措施,以慢病先行推进深圳市福田区分级诊疗模式构建。 结果 经过1年的实施,构建了具有深圳福田区特色的分级诊疗体系,以福田区慢性病防治院为桥梁的分级诊疗运行情况良好。搭建了分级诊疗平台,各辖区内各医疗机构实现了诊疗信息互联互通。在分级诊疗实施过程中较好地落实了"优先挂号、优先接诊、优先检查、优先住院"服务。全科医生和专科医生整合的学科共同体内涵得到明显提升。实施分级诊疗以来,高血压和糖尿病患者在社区健康服务中心就诊人数比实施前同期增长18.2%和26.9%。高血压和糖尿病规范化管理人数增长速度是实施前同期新增高血压人数的3倍以上,新增糖尿病人数的2.18倍以上。实施分级诊疗前,没有患者下转回社康中心进行康复治疗,实施分级诊疗后,下转患者3 057人。 结论 深圳市福田区构建的以慢性病防治院为桥梁、全方位推进分级诊疗的模式效果显著,值得参考。 

Implementation on hierarchical medical system in Futian taking the hospital for prevention and treatment of chronic disease as the bridge

Objective To implement and evaluate hierarchical medical system in Futian taking the hospital for prevention and treatment of chronic disease as the bridge. Methods To establish the hierarchical medical system by series of measures:building regional medical association, promulgating hierarchical medical programme, taking the Futian hospital for prevention and treatment of Chronic Disease as the bridge, Setting up a discipline alliance, Enhancing the ability of health care, modifying two-way referral service process, information construction. The overall situation effect of the hierarchical medical system was evaluated. Results Hierarchical medical system in Futian has been established successfully since June, 2016. Evaluation shown that the hierarchical medical system was running well, the priority registration, priority admission, priority examination, and priority hospitalization service for the patients were implemented, and collaboration between general practitioners and specialists were significantly was improved. The number of patients with hypertension and diabetes attending community health center increased by 18.2% and 26.9% compared with the same period before implementation of hierarchical medical system. The increment speed of standardized management for hypertension and diabetes patients were more than 3 times and 2.18 times compared with the same period before implementation of hierarchical medical system. There were 3 057 patients referral to the community health center from hospital, while there was no patients' referral to the community health center before June, 2016. Conclusion The effect of the hierarchical medical system in Futian taking the hospital for prevention and treatment of chronic disease as the bridge is Satisfied, which is worth extending.