国内分级诊疗现状的系统评价

发布时间：2018-06-01 20:33

本文选题：分级诊疗 + 系统评价　；参考：《中国药房》2017年34期

【摘要】：目的:系统评价国内分级诊疗现状和面临的问题,为国家卫生决策提供参考。方法:以"分级诊疗"为关键词检索自各数据库建库起至2016年6月发表于中国知网、维普、万方数据库中的相关文献,全面收集国内分级诊疗现状的研究,从结局评价指标和面临的问题两方面进行系统评价。结果:共纳入23项研究,其中18项为调查研究,3项为回顾性/调查研究,1项为回顾性研究,1项为随机对照研究。结局评价指标中,9项研究以对分级诊疗的认知度、知晓度为评价指标,结果表明群众认知度、知晓度不高,而医护人员较高;7项研究以实施现状为评价指标,结果表明实施现状总体不理想;3项研究以人力资源为评价指标,结果表明基础医疗机构卫生人力资源水平不理想;3项研究以满意度为评价指标,结果表明群众满意度较高;2项研究以实施模式为评价指标,结果表明目前的模式较好地促进了分级诊疗的施行;2项研究以费用为评价指标,结果表明个人支付费用较高。面临的问题中,19项研究提出分级诊疗相关制度不完善,16项研究提出基层医疗机构水平不足,7项研究提出患者缺乏基层就医习惯,7项研究提出宣传不足。结论:目前国内分级诊疗的现状还不理想,还面临很多问题。通过提高基层医疗水平、完善分级诊疗制度、提高患者基层就医意愿、加大分级诊疗的宣传,可深入推进分级诊疗的实施,为卫生决策提供客观和有价值的参考。
[Abstract]:Objective: to evaluate the status quo and problems of classified diagnosis and treatment in China, and to provide reference for national health decision making. Methods: the key words of "classified diagnosis and treatment" were retrieved from the database from the establishment of each database to June 2016, published in the database of China's Zhiwang, Weipu, Wanfang, and collected the current status of classified diagnosis and treatment in China. Systematic evaluation is carried out from two aspects: the outcome evaluation index and the problems faced. Results: a total of 23 studies were included, of which 18 were investigated and 3 were reviewed / investigated. One was a retrospective study and one was a randomized controlled study. Among the outcome evaluation indexes, 9 studies were based on the degree of recognition and awareness of graded diagnosis and treatment. The results showed that the awareness of the masses was not high, while the implementation of the current situation was regarded as the evaluation index in 7 studies. The results showed that the overall implementation of three studies on human resources as an evaluation index, the results show that the basic medical institutions health human resources level is not ideal. The results showed that two studies with high mass satisfaction took the implementation model as the evaluation index. The results showed that the current model promoted the implementation of graded diagnosis and treatment better and two studies took the cost as the evaluation index. The results showed that the personal payment cost was higher. Among the problems faced, 19 studies suggest that the related system of grading diagnosis and treatment is not perfect and 16 studies suggest that the level of primary medical institutions is insufficient. 7 studies suggest that patients lack the habit of primary medical treatment. 7 studies put forward insufficient publicity. Conclusion: the present situation of classified diagnosis and treatment in China is not ideal, and many problems are faced. By improving the level of primary medical treatment, perfecting the system of graded diagnosis and treatment, improving the willingness of patients to seek medical treatment at the grass-roots level, and increasing the propaganda of graded diagnosis and treatment, the implementation of graded diagnosis and treatment can be promoted deeply, and the objective and valuable reference for health decision-making can be provided.
【作者单位】：四川大学华西第二医院药学部;四川大学华西第二医院循证药学中心;出生缺陷与妇儿疾病教育部重点实验室;
【基金】：2015年中国卫生思想政治工作促进会城市医院分会分级诊疗相关课题
【分类号】：R197.1

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