Mutual referral: a survey of GPs in Beijing
Mutual referral: a survey of GPs in Beijing
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DOI：
10.1093/fampra/cmr122
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发表时间：
2012-08-01
期刊：
影响因子：
2.2
通讯作者：
Wang, Wei
中科院分区：
文献类型：
--
作者：
Du, Juan;Lu, Xiaoqin;Wang, Wei
中国最近一直在进行医疗体制改革。为了降低医疗服务的成本和提高医疗服务的公平性，政府试图重建转诊系统。本研究旨在评估北京市相互转诊试点项目的现状、影响转诊行为的感知因素以及有助于改善当前转诊流程的变化。问题是从基于名义小组技术的正式共识过程中挑选出来的。138个社区卫生服务中心中有125个(90.6%)回答了调查。76个(61.8%)社区卫生服务中心报告相互转介制度是可行的。26个(21.1%)社区卫生服务中心报告说，相互转介计划运行顺利。诊断/管理的不确定性和能否获得特定的医学专业兴趣或技能是被认为影响转诊行为的两个最常见的因素。在医院设立专门的部门接受转诊，并使用转诊指南是最有可能改善当前转诊流程的首选选择。由于北京尚未建立社区卫生服务机构全科医生的看门人制度，大多数社区卫生服务医生同意，为了确保转诊的顺利进行，医院应该指定一个专门的部门来接收转诊患者。应制定关于转诊的官方指南，卫生当局应加强对转诊的监督。
China has been engaged in the process of reforming its health care system recently. The government has attempted to rebuild the referral system to lower cost and enhance equity of the medical services.This study was undertaken to evaluate the current status of mutual referral pilot programme, perceived factors that affect referral behaviour and changes that would improve the current referral process in Beijing.Using a cross-sectional study design, we sent a postal questionnaire to 138 urban district community health service (CHS) centres in Beijing. Questions were chosen from a formal consensus process based on a nominal group technique.One hundred twenty-five of 138 (90.6%) CHS centres responded to the survey. Seventy-six (61.8%) CHS centres reported that the mutual referral system was feasible. Twenty-six (21.1%) CHS centres reported that the mutual referral programme was running smoothly. Uncertainties of diagnosis/management and access to particular medical specialty interest or skills were the two most common factors that were suggested as affecting referral behaviour. The presence of a dedicated department to accept referrals in hospitals and the use of referral guidelines were the most preferred choices as likely to improve the current referral process.Since a system of gatekeeper role by GPs at CHS organizations has not been established in Beijing, most CHS doctors agree that to ensure the smooth operation of referrals, a dedicated department should be assigned by hospitals to receive referred patients. Official guidelines on referral should be developed, and health authorities should strengthen their supervision of referrals.