摘要
Abstract
Objective To explore the implementation status of hierarchical medical system in Chaoyang District,Beijing,and analyze the existing challenges during the implementation process,in order to provide recommendations for further development of this system.Methods We collected the survey data for the period of August 2015 to September 2016 of the members of 26 regional medical consortiums (RMCs),and the performance appraisal data for the same period of 42 community health service centers (CHSCs) in Chaoyang District,Beijing.We assessed the implementation status of the hierarchical medical system in this district from the aspects of medical service workload,number of dual referrals,medical talents exchange and scores of 6 quality indicators for basic medical services.Results Compared with 2015,the average number of outpatient visits,emergency visits,inpatient visits and downward referrals increased 3.45％,14.55％,13.78％,67.34％,respectively in the upper-level hospitals in the 26 RMCs in 2016.The average number of outpatient visits,emergency visits,inpatient visits and experts from the upper-level hospitals increased 8.52％,5.63％,28.27％,544.33％,respectively in the Community helath service organlzations (CHSOs) in the 26 RMCs in 2016 compared with 2015.The average scores of residents'health records management,health management for the elderly and quality of medical services for 42 CHSCs in 2016 were not significantly different from those in 2015 (P ＞ 0.05).The 42 CHSCs obtained higher scores for health management for hypertension and health management for type 2 diabetes but lower scores for rational use of medicines in 2016 compared with 2015 (P ＜ 0.05).Conclusion The implementation of the hierarchical medical system has achieved certain positive effects in Chaoyang District,specifically,the medical service workload in both the upper-level hospitals and CHSOs in the 26 RMCs have increased,and the number of downward referrals have increased as well;the capabilities of chronic disease management for CHSCs in this district have demonstrated enhancement,but the rational use of drugs in these institutions needs to be improved.关键词
分级诊疗/实施效果/北京Key words
Hierarchical medical system/Implementation effect/Beijing分类
医药卫生
