Objective To investigate the types of diseases suitable for downward referral from hospitals to community health centers and to provide suggestions for targeting and coordinated services provided by different medical settings. Methods In July 2014, we enrolled 51 subjects who participated in a " medical group" coordination mode in Zhenjiang and a" straight pipe mode" in Wuhan. Questionnaire survey was conducted concerning the basic information and the cognitive appraisal of the features and modes of diseases suitable for coordinated service. The subjects were asked to rank relevant items from " the first grade" to " the third grade" based on their importance by assigning 3, 2 and 1 to the items. Results Among the subjects,54. 9% (28/51) thought that the primary feature for downward referral is that the disease is at stable convalescence; the rank of importance shows that first three features are that the disease is at stable convalescence ( 115 ) , the disease itself is suitable for community care (84) and the patient has the intention for downward referral (52) . Among the subjects, 49. 0% (25/51) thought the primary issue hospitals should consider in downward referral is community medical level; the rank of importance shows that first three issues hospitals should consider in downward referral are community medical level (109), the intention of patient for downward referral (77) and united wards established in communities with the help of large-scale hospitals (75) . Among the subjects, 45. 1% (23/51) thought that cerebrovascular diseases like stroke are the primary diseases that are suitable for downward referral after disease get stabilized; 54. 9% (28/51) thought that hypertension is the primary disease that is suitable for outpatient services in communities after discharge; 39. 2% (20/51) thought that cerebrovascular diseases like stroke are the primary diseases that need regular home follow-up visits after discharge. The rank of importance shows that the first three diseases that are suitable for downward referral to communities after disease get stabilized are cerebrovascular diseases like stroke ( 91 ) , hypertension (62) and diabetes (57); the first three diseases that need outpatient treatment in communities after discharge were hypertension (112), diabetes (86) and cerebrovascular diseases like stroke (40); the first three diseases that need regular family follow-up visits are hypertension (82), cerebrovascular diseases like stroke (77) and diabetes (73) . Conclusion Diseases being at stable convalescence is the primary factor that should be considered in downward referral; community medical level is the primary factor that large-scale hospitals should consider when they make downward referral; the types of diseases suitable for coordinated service vary with different courses of diseases. We suggest definite referral criteria should be made, the level of medical services in community service settings should be improved, united wards between different medical settings should be established, coordinated services for appropriate diseases between different settings should be conducted, and patients should be given guidance to accept coordinated services.%目的：探讨社区卫生服务机构适宜接受下转服务的疾病类型，为促进机构间开展有针对性的协作服务提供建议。方法2014年7月，采用典型抽样法选取镇江某“医疗集团”协作模式和武汉某“直管模式”下的知情者51名为研究对象，对其进行问卷调查，内容包括知情者的基本情况及对适宜协作疾病特点、形式等认知评价，要求知情者按重要程度由“第一位”到“第三位”对相关问题进行评价，并分别赋值为3、2、1分。结果54．9%(28/51)的知情者认为疾病处于稳定康复期是适宜下转疾病应具备的首要特点；按重要程度得分排序显示，适宜下转疾病应具备的特点前三位分别为疾病处于稳定康复期(115分)、疾病本身适宜社区照护(84分)、有下转的意愿(52分)。49．0%(25/51)的知情者认为社区医疗水平是医院下转患者到社区需注意的首要问题；按重要程度得分排序显示，医院下转患者到社区需注意的问题前三位分别为社区医疗水平(109分)、患者自身下转意愿(77分)、大医院帮助社区合作建立联合病房(75分)。45．1%(23/51)的知情者认为脑卒中等脑血管疾病是疾病稳定期后适宜下转到社区住院治疗的首要疾病；54．9%(28/51)的知情者认为高血压是出院后适宜在社区进行门诊治疗的首要疾病；39．2%(20/51)的知情者认为脑卒中等脑血管疾病是出院后有必要定期进行家庭随访的首要疾病。按重要程度得分排序显示，疾病稳定期后适宜下转到社区住院治疗的疾病前三位分别为脑卒中等脑血管疾病(91分)、高血压(62分)、糖尿病(57分)；出院后适宜在社区进行门诊治疗的疾病前三位分别为高血压(112分)、糖尿病(86分)、脑卒中等脑血管疾病(40分)；出院后必要进行定期家庭随访的疾病前三位分别为高血压(82分)、脑卒中等脑血管疾病(77分)、糖尿病(73分)。结论疾病处于稳定康复期是判断患者适宜下转的首要因素；社区医疗水平是大医院考虑是否下转患者的首要因素；不同病程中适宜协作疾病种类不同。建议通过明确转诊标准，提高社区卫生服务机构医疗服务水平，建立机构间联合病房等方式，对适宜疾病开展机构间协作服务，引导患者接受协作服务。
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