Study On Effectiveness And Feasibility Of Two-way Referral System

May 12,2006,the Shenzhen municipal government officially promulgated the "Shenzhen Interim Measures for Labor's Health Insurance," which means work on the implementation of the insured services "bind the community" medical treatment,forming the nation's first clinic in a community in the first prototype of the system,followed by Shenzhen city,laid the foundation to carry out a two-way referral.This study selected Shenzhen Guanlan Hospital which runs two-way referral as an example, evaluate the effect of two-way referral system implemented. Objective: By comparing the Guanlan hospital data related to referral before and after the running two-way referral, patient awareness of the two-way referral system and medical staff satisfaction and referral on two-way "knowledge","believe" and"behavior" to analyze Guanlan two-way referral hospital status and assessment of Guanlan hospital to run a two-way referral system to implement the measures of effectiveness and feasibility; study on the current two-way referral system of primary care health care paradigm shift in the role; study the operation of two-way referral mechanism to ensure mechanism for referral criteria and referral procedures, so as to improve two-way referral system, the development of relevant health insurance policy, promotion of community consultation system for the first reasonable suggestion.Method: Two-way referral hospital in Guanlan to carry out the work of the pilot run before the collection of hospitals and various community health service center referral month the number of outpatient volume and other related data; of different medical institutions and health care services in different medical institutions for patients and accompanying family members conduct baseline survey. Guanlan for the baseline survey with two-way referral hospital development interventions; intervention measures to implement the 3 months after the operation on the Guanlan -referral hospitals to implement performance evaluation, through comparative analysis of the data to evaluate two-way referral hospital run Guanlan the effectiveness of interventions and feasibility. Results: 1. From July 2008 to February 2009, all community health centers on the transfer of patients to hospital outpatient services account for the month increased by 2.82% percentage of the hospital transferred to the Community Health Centre under the 7.39% increase in the proportion of patients 2. Satisfaction to the two-way referral system increased by 8.3%. 3.Turn of reasons consistent with the referral requirements in the guidelines 4.Two-way referral system to save costs and seek medical treatment and health services have an active role in visiting time 5. Satisfaction to the two-way referral process increased by 9.5%. 6 Aawareness of medical staff on the concept of two-way referral rose 4.9%. 7. Evaluation of medical staff on the need to carry out two-way referral increased by 5.8%; positive assessment of the feasibility of the implementation of two-way referral system on the current increase of 2.5%; positive assessment of the implementation of two-way referral system in a reasonable way on the current increase of 6.9%; on the current whether two-way referral in hospital run smoothly survey, select the unimpeded access, an increase of 14.9%; evaluation on two-way referral system is conducive to doctors'ability to improve business, increased by 5.0%; on the two-way referral system is conducive to strengthening specialist and general medical practitioners, with the positive evaluation of 8.3%; on the current two-way referral pilot evaluation of the overall effect in Guanlan hosptial, select the best overall effect increase the proportion of 18.9%. Conclusion: Two-way referral in Guanlan hospital has begun to take systematic,standardized , Community health management and community first diagnosis system of Shenzhen,medical insurance policy and the Guanlan hospital original two-way referral guide,two-way referral information platform on a nationwide two-way referral can learn from experience.