摘要
目的:了解医联体工作存在的难点与痛点,为未来进一步完善医联体建设、落实分级诊疗提供思路。方法:以中南大学湘雅医院正式职工为调查对象,排除进修生、研究生。采用自行设计的《医联体工作认知情况调查》问卷,内容包括基本情况、整体认知情况、不同合作模式认知情况、相关政策了解程度及对医联体建设工作的意见。结果:共计回收有效问卷576份,问卷回答完整率100%。59.55%的人对医联体建设工作表示满意,约35.07%的人态度中立,5.38%的人不满意;92.88%的人支持医联体建设;31.6%的人了解医联体或分级诊疗相关政策,68.41%的被调查者不了解;医联体的6种合作模式中,托管医院(97.2%)、省内定点指导双向转诊(84.03%)及远程医学服务(82.99%)知晓率较高;内部机制未理顺导致工作效率不高(60.71%)、双向转诊难以实现(58.93%)、外部配套政策不足(58.93%)、临床科室任务重难以负荷额外工作任务(50%)被普遍认为是当前医联体建设中突出存在的问题。结论:建议医联体应加强顶层设计,妥善处理内部与外部、短期与长期的关系;积极探索新的模式,寻找医联体内利益平衡点;加快信息化建设,促进资源共享提高工作效率;完善内部制度,构建医联体运行框架。
Objective:In order to find out the difficulties in the implementation of the medical cluster,This study attempts to make some suggestions which improving the construction of medical cluster and Hierarchical Medical System.Methods:This research was carried out from August to September 2019.Formal employees of Xiangya Hospital of Central South University were used as survey objects,and advanced students and graduate students were excluded.The self-designed"Medical Cooperative Work Cognition Survey"questionnaire was issued in the form of an online questionnaire,which included basic information,overall attitude,attitude of different cooperation modes,relevant policy understanding,and the opinion of medical cluster.Results:576 questionnaires were distributed,100%completed.59.55%of them expressed satisfaction with the Medical Alliance,35.07%were neutral,and 5.38%were dissatisfied;92.88%support the Medical Alliance,2.6%oppose;31.6%understand the related policies,68.41%do not understand;The top three knowledge of the six modes of the Medical Alliance are Hosting hospital,Fixed-point guidance in the province and Telemedicine.The low efficiency due to the imperfect internal mechanism(60.71%),inaccessible two-way referral(58.93%),lack of supporting policies(58.93%),Unbearable extra work tasks beyond clinical routine(50%)were generally considered problem during medical cluster processing.Conclusion:It is recommended that hospitals should strengthen the strategic design and properly handle the internal and external,short-term and long-term relationships.It is important that exploring new models in order to find the balance of interests within the alliance.Information construction can promote resource sharing and work efficiency.The perfect internal working mechanism is vital for the cluster.
作者
喻丹
张茂红
钱招昕
梁琳
范宇炜
董婷
YU Dan;ZHANG Maohong;QIAN Zhaoxi;LIANG Lin;FAN Yuwei;DONG Ting(Xiangya Hospital Central South University,No.87,Xiangya Road,Changsha,410008,Hu'nan Province,PRC)
出处
《中国医院》
北大核心
2021年第1期36-40,共5页
Chinese Hospitals
基金
湘雅医院-北大未名临床与康复研究基金(xywm2015II11)
中南大学湘雅医院管理研究基金(2015GL03)。
关键词
医联体
核心医院
分级诊疗
medical cluster
core hospital
hierarchical medical system
