目的:以新型二级宏观医疗卫生服务系统为基点,进一步完善以社区为基础的医疗卫生服务理论体系.建立新型医疗卫生服务系统中医院与社区“双向转诊”体制。方法:前期研究构建医院与社区互动模型、卫生服务理论、文献综述方法。结果:经医院与社区互动模型获得“双向转诊”主要主体和病人流动路径.分析“双向转诊”影响因素,揭示“双向转诊”机制,并提出政策建议。结论:医院与社区“双向转诊”机制是新型宏观医疗卫生服务系统二级互动的关键部分,研究可为医院与社区整体互动提供理论依据。
Objective To construct the dual referral mechanism between hospitals and communities based on the new type Health Delivery System (HDS) , improve the theoretical system on new type HDS which based on community health service. Methods A system dynamic model was used including analysis of routine data and interviews supplemented by analysis of published literature. Results patients, hospitals, community and government are main parts in dual referral procedure. Chooses while seeking medical advice, standards of dual referral, management of community, are factors affecting dual referral. Policy advices were advanced in the end. Conclusions the mechanism of dual referral between hospital and community is the key of exchanging on medical funds, medical equipments and personal resources between that two. Results of research could be theory evidences for improvement of new type HDS.