社區醫院雙向轉診之策略規劃

Strategies of Bidirectional Referral System in Community Hospital

邵詩媛(Shi-Yuan Shao) ； 蔡良敏(Liang-Miin Tsai)

《醫務管理期刊》 6卷2期 (2005/06) Pp. 190-200

https://doi.org/10.6174/JHM2005.6(2).190

摘要

整合性及策略性的管理式照護，尤其是強調社區醫療資源運用的社區醫療，近年來在台灣及世界先進國家，備受重視。台灣在傳統的封閉式醫療系統下，社區醫療功能不足，雙向轉診不夠活絡，已導致院所間激烈競爭，並嚴重浪費醫療資源。本研究以個案研究方式，先行對某區域之基層醫師轉診意態進行問卷調查，並將研究結果，用以建立一個有效率的雙向轉診運作規劃，以做為一實證探討。
研究結果發現：基層醫師不願將病患轉出之主要考量因素中，以(1)轉入醫院醫療品質不佳，(2)解釋病情不顧及基層醫師之立場，(3)病人病情無回覆，及(4)未將病人轉回，造成病人流失，為最主要之四大原因。因此，針對上述因素，個案醫院轉介中心積極改善轉診服務品質、提升醫師回覆效率，並積極將病人轉回原社區基層醫療等。在這些努力之下，該轉診中心短期內獲致良好的服務成效：不僅在轉介個案數量上有明顯增加，轉介病人及機構之滿意度亦獲改善。個案醫院對雙向轉診之理念、規劃與操作，應能提供醫界參考。

關鍵字

社區醫療 ； 雙向轉診

並列摘要

The integrated and strategic health care management, particularly based on community medical resources, is recently emphasized in Taiwan as well as other countries. Under the traditional closed medical system, the lack of community health care integration and the inhibited bidirectional referral services have led to a vicious competition between hospitals and substantial wasting in medical resources. This study is aimed to investigate the attitudes and opinions of the local primary physicians in referring patients to a community hospital, in order to generate an effective bidirectional referral system in this community. The results indicate that the major concerns of the primary physicians in referring patients to the hospital include: 1.the quality of medical care, 2.whether the situation of primary physicians is covered while making explanation, 3.the quality of the information reply, and 4.whether the patients are referred back after management. According to the results, the community hospital made substantial changes in the referral service system to meet the needs and concerns of the local primary physicians. After a short term period, the initial results demonstrate that the changes and efforts in the referral system have resulted in a remarkable growth in the referred case number as well as an improvement in the satisfactions of the patients and primary physicians.

並列關鍵字

Community Health Care ； Bidirectional Refferal System

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