摘要
目的应用扎根理论方法探讨贵州省双向转诊的影响因素并提出对策,为顺利实施双向转诊提供参考依据。方法2017年7—10月对贵州省9个市(州)45家医疗机构的医院管理者、临床医生、患者共135名进行半结构化访谈,采用三级编码提取、归纳双向转诊问题及影响因素。结果经过三级编码,梳理出715个概念、81个范畴、19个主范畴和4个核心范畴,形成4条脉络:患者转诊行为脉络、医生转诊抉择行为脉络、医疗机构间转诊衔接脉络、转诊相关配套政策脉络。结论影响患者上转和下转的因素较多,转诊中患者的决定性作用及医疗机构间缺乏有效联系是主要制约因素。加强双向转诊政策宣传,保持医疗机构间的密切联系以畅通转诊流程和保障病人安全,完善上下级医疗机构间常用药品对接,为患者提供连续性的医疗服务是双向转诊的必要条件。
Objective To investigate the influence factors of two-way referral in Guizhou Province based on grounded theory in order to provide references for the optimization of two-way referral process.Methods From July to October,2017,a total of 135 interviewees including hospital managers,clinicians and patients were selected expediently from 45 medical institutions in 9 districts in Guizhou Province,and they were interviewed with semi-structured syllabus.The existing problems and influence factors of two-way referral were extracted and concluded through three-grade coding.Results After three-grade coding,715 concepts,81 categories,19 main categories and 4 core categories of two-way referral were revealed.4 clues including patient’s referral behavior,doctor’s referral decisions,the referral between medical institutions and related supporting policies of referral were finally formed.Conclusion There are many factors influence the effects of two-way referral.The authority of patients and insufficient communication between medical in?stitutions were main constraints factors of two-way referral.So,promoting publicity of two-way referral,keeping connection between medical institutions for smoothing the referral process and ensuring the safety of patients,maintaining consistency in drug category in medical institutions are necessary for two-way referral.
作者
张年
余昌胤
黄辉华
袁成菊
ZHANG Nian;YU Chang-yin;HUANG Hui-hua;YUAN Chengju(School of Management,Zunyi Medical College,Zunyi,Guizhou,563000,China)
出处
《中国医院管理》
北大核心
2018年第11期14-16,共3页
Chinese Hospital Management
基金
贵州省卫生和计划生育委员会委托课题(gzwjwyzc2015-01)
遵义医学院研究生社会实践项目(zy-ysh009)
关键词
双向转诊
影响因素
扎根理论
质性研究
贵州
two-way referral
influencing factor
grounded theory
qualiative analysis
Guizhou