Objective To analyze the operation status of the two - way referral system for patients with chronic hepatitis B virus infection between specialized hospital of infectious disease and community health center. Methods A cohort of 1 019 patients with chronic hepatitis B virus infection was established in the national eleventh five-year plan,while 68 subjects were lost in follow - up. In order to make up the loss, we enrolled 68 patients with chronic hepatitis B virus infection who accorded with the inclusion and exclusion criteria from Beijing Ditan Hospital Affiliated to Capital Medical University from January 2013 to January 2014. According to whether the subjects had been referred to community management in the two-way referral system,they were divided into two groups:non community management group(n=497)and community management group(n=522). Comparison was made between the two groups in general data. The reasons why some patients were not willing to be referred to community management and the operation status of the green passage of the two - way referral system were summarized. Results (1)Of the 1 019 subjects,51. 2%(522/1 019)were willing to be referred to community management in the two -way referral system and 48. 8%(497/1 019)were unwilling to be referred to community management. The two groups were not significantly different(P>0. 05)in gender,average age,disease type and cases that had been lost. (2)The reasons why some patients were unwilling to be referred to community management were the worry for being discriminated,the concern for low professional level of community doctors,the worry for the lack of drug categories there and the worry for inaccurate examination results,and the proportions of the four reasons were 11. 5%(57/497),91. 5%(455/497),95. 0%(472/497) and 78. 3%(389/497)respectively. (3) From March to Ocboter in 2013,there were 69 patients with chronic hepatitis B virus infection who smoothly received two-way referral through the green passage. From January 2013 to January 2014,there were all together 103 patients with chronic hepatitis B virus infection who smoothly received two - way referral through the green passage. Conclusion The green passage of the two-way referral system was highly feasible and smooth in operation. The worry for the lack of drug categories and the worry for low professional level of community doctors are the main reasons for some patients being unwilling to be referred to community management in the two-way referral system.%目的：了解慢性乙型肝炎病毒感染者专科医院和社区卫生服务中心双向转诊的运行情况。方法以“十一五”规划中建立的1019例慢性乙型肝炎病毒感染者随访队列为基础，因队列存在部分病例缺失，于2013年1月—2014年1月在首都医科大学附属北京地坛医院选取符合本研究纳入及排除标准的门诊或住院慢性乙型肝炎病毒感染者68例，将队列完善至1019例。根据患者参与双向转诊社区管理情况，将其分为未参与社区管理组（ n=497）和参与社区管理组（n=522）。比较两组一般资料，分析患者不愿意参加双向转诊社区管理的原因，并总结双向转诊绿色通道运行情况。结果（1）1019例慢性乙型肝炎病毒感染者中有51.2%（522/1019）愿意参加双向转诊社区管理，有48.8%（497/1019）不愿意参加双向转诊社区管理，两组患者性别、平均年龄、疾病类型及脱落病例比较，差异无统计学意义（P>0.05）。（2）患者不愿意参加双向转诊社区管理的原因分别为担心歧视、担心社区医生业务水平低、担心社区卫生服务中心药物种类不全、担心社区卫生服务中心检查不准确，所占比例分别为11.5%（57/497）、91.5%（455/497）、95.0%（472/497）、78.3%（389/497）。（3）2013年3—10月，朝阳区共有69例慢性乙型肝炎病毒感染者参与了双向转诊绿色通道；2013年1月—2014年1月，10家推广此模式的社区卫生服务中心共有103例慢性乙型肝炎病毒感染者参与了双向转诊绿色通道。结论双向转诊绿色通道可行性较高，运行较顺畅，担心社区卫生服务中心药物种类不全和担心社区医生业务水平低是患者不愿意参加双向转诊社区管理的主要原因。
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