Practice And Discussion On The Status Of Two-way Referral Platform In A Hospital In Anhui

Objective 1.Based on the two-way referral platform for statistical analysis of the data,understand the general condition of patients,referral orientation,referral rate,breach of the direction of referral referral departments,inspection situation and existing problems.2.Through the analysis of the referral department and the examination of the referral,the needs of the patients and the primary hospitals are understood,and the promotion and construction plan of the two-way referral platform is explored.Methods The First Affiliated Hospital of Medical University Of Anhui set up a referral platform in April 2015.And signed of "medical couplet" with multiple community health centers and the established two-way referral cooperation.The two party hospital referred patients through the two-way referral platform.The data of general information,referral Department data and referral data from January January 2016 to December 31,2017 were collected from the platform.SPSS 21 statistical analysis software and Excel software were used for enumeration and analysis.Variance analysis was used to compare multiple groups.P<0.05 thought the difference was statistically significant.Results 1.The gender of the patients who participated in the two-way referral was different,and the age groups were different,and the difference was statistically significant(P<0.05).2.970 people(about 99.79%)were transferred from the primary hospital to the First Affiliated Hospital of Medical University Of Anhui(later called"transfer").2 people(about 0.21%)were transferred from the First Affiliated Hospital of Medical University Of Anhui to the primary hospital(later called "transfer").In all the referral patients,852 were wanting to visit specialist(about 87.65%)and 119(about12.24%)were wanting to be examined.This rate of renege is high,accounting for about6.58% of all referrals;3.In the application of the referral clinic,the majority of the applicants were gynecologic,cardiovascular,Department of Endocrinology,Gastroenterology,Department of Dermatology,reproductive center,neurology,ophthalmology and prenatal diagnosis center.4.In the application of examination and inspection of referral,the majority of applications for ultrasound examination,gastroscopy and magnetic resonance examination.5.In 2016 and 2017,the annual referral volume/the total outpatient volume of the large hospital,the annual referral volume / the outpatient volume in the primary hospital accounted for a very small share.There was a linear regression relationship between referral and outpatient visits.Conclusions 1.Solving the problem of economic interests and perfectting the mechanism of incentive and the mechanism of assessment are the effective way to solve the problem of "easy to turn up and difficult to turn" in two-way referral.At the same time,in order to improve the attractiveness of primary hospitals,governments at all levels and cooperative general hospitals should implement policies and substantive assistance measures for primary hospitals.According to the population age composition ratio,health and disease status,residents' economic level and needs of different groups,we should make rational allocation and planning of regional health resources.2.We should pay attention to the propaganda of two-way referral and strengthen the design and implementation of the propaganda program.Increasing the awareness of two-way referral by medical and female people as the main population of two-way referral.3.Strengthen the cultivation of the spirit of the contract of the masses,reduce the referral rate of breach of contract.To guide and encourage related activities in social and hospital,so that to strengthen the participation of the masses and to encourage the masses to abide by their promises.At the same time,we should strengthen the construction and improvement of relevant systems,and take medical insurance as theentry point to restrict and manage the people who participate in two-way referral.4.Pay attention to the two-way referral platform with the demand-oriented way,general hospital should actively open Easy Access departments for primary hospital,and strengthen special departments to support primary hospital focused.The government should strengthen the implementation of rational planning of above inspection project,form regional inspection center,regional inspection center,and the data sharing and integration control by "Internet plus medical platform.