目的：通过分析上海市某社区卫生服务中心双向转诊现状，探讨双向转诊过程中发现的问题，提出相应对策。方法：查阅黄浦区五里桥街道社区卫生服务中心2012年1月—2014年12月双向转诊登记，收集统计相关数据并进行分析。结果：2012、2013和2014年该社区卫生服务中心上转患者分别为1679人次、1778人次和1635人次，分别占门诊总人次的0.48%、0.48%和0.42%。转诊至区医联体医院的患者占转诊总人数的21.94%。转出对象均参加居民基本医疗保险，转出原因主要是社区条件限制无法进行治疗（配药）和检查。转出的疾病中，主要为心血管系统疾病、外科疾病、精神类疾病。结论：双向转诊在我中心尚未真正实现，全科医师“守门人”的作用尚未真正发挥。应从政策保障、完善医保制度、搭建信息平台、提升社区全科医师能力等方面得以实现。%Objective: Through the analysis of the situation of the two-way referral of a community health service center in Shanghai to discuss the problems found in its process and propose the corresponding counter-measures.Methods: The two-way referral registration of Wuliqiao Community Health Service Center from January 2012 to December 2014 was reviewed and related statistical data were collected and analyzed.Results: The number and frequency of patients referred were 1 679 in 2012, 1 778 in 2013 and 1 635 in 2014, and accounted for 0.48%, 0.48% and 0.42% of the total number of the outpatients, respectively. The patients referred to the district medical conjoined hospitals accounted for 21.94% of the total number of the referral. The referred objects participated in the resident basic health insurance. The reason of the referral was mainly the limited community condition unable to do the treatment (dispensing) and examination. The diseases referred were mainly the cardiovascular system disease, surgical diseases, and mental illness. Conclusion:The two-way referral has not yet been really realized in our centre and the general practitioners have not really played the role of the “gatekeeper”. The two-way referral should be realized through the policy support, the health insurance system improvement, information platform establishment, and community general practitioners ability improvement, etc.
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