摘要
目的本研究以北京市通州区某区域纵向医联体为样本,分析新冠肺炎疫情下医联体的运行情况,以问题为导向,提出新发重大传染病疫情下完善医联体建设的意见和建议。方法收集医联体各成员单位2019年12月、2020年1月、2020年2月门诊人次、转诊人次、会诊人次、进修培训人次等数据,运用描述性分析、秩和检验等方法进行统计分析。结果医联体内各医疗机构受疫情影响门诊人次均有大幅下降;2019年12月、2020年1月、2020年2月,基层医疗卫生机构上转人次标准化值分别为212、45、4,差异有统计学意义(H=6.781,P=0.034);核心医院下转人次分别为308、146、20,差异有统计学意义(H=7.573,P=0.023);医联体成员单位间会诊人次分别为32、20、0,差异有统计学意义(H=8.873,P=0.012);进修培训人次分别22、2、0,差异有统计学意义(H=11.225,P=0.004)。结论新冠肺炎疫情对医联体建设造成一定影响,医联体在疫情防控中发挥作用不明显。下一步应完善畅通双向转诊机制,应用远程会诊技术拓宽联动机制,提升基层医疗卫生机构传染病预警、诊断能力,切实发挥区域纵向医联体在新发重大传染病疫情防控中的作用。
Objective In the study,a regional and vertical medical consortium in Tongzhou District,Beijing was taken as a sample.This study aimed to analyse the operation of the medical consortium under COVID-19,and take the problem as the guide to put forward suggestions for improving the construction of medical consortium under major emerging infectious diseases.Methods The data of each member unit of the medical consortium in December 2019,January 2020,and February 2020 were collected,including outpatient visits,referral visits,consultation visits,and refresher training visits.Performed statistical analysis by descriptive analysis,rank sum test,and other methods.Results The number of outpatient affected by epidemic decreased significantly in medical institutions in medical consortium.In December 2019,January 2020 and February 2020,eliminated the impact of outpatient volume,the standardized values of the number of patients transferred from primary medical institutions were 212,45 and 4 respectively,and the difference was statistically significant(H=6.781,P=0.034).The number of patients transferred from core hospitals were 308,146 and 20 respectively,and the difference was statistically significant(H=7.573,P=0.023).The number of consultation in the medical consortium were 32,20 and 0 respectively,and the difference was statistically significant(H=8.873,P=0.012).The number of refresher training among member units in medical consortium were 22,2 and 0 respectively,and the difference was statistically significant(H=11.225,P=0.004).Conclusion The construction of medical consortium has been affected during COVID-19 epidemic to some extent,and the function of medical consortium in the prevention and control of epidemic was not obvious.We should improve the two-way referral mechanism,apply remote consultation technology to broaden the linkage mechanism,and improve the ability of early warning and diagnosis,and give full play to the role of regional and vertical medical consortium in the prevention and control of new major emerging infectious diseases.
作者
田昕
李晓轩
吴静
TIAN Xin;LI Xiao-xuan;WU Jing(Department of Hospital Management Office,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床和实验医学杂志》
2020年第11期1121-1124,共4页
Journal of Clinical and Experimental Medicine
基金
北京市医院管理局“青苗”计划专项经费资助(编号:QML20180109)
北京市属医院科研培育项目资助(编号:PG2019001)。
关键词
新冠肺炎
疫情
区域医联体
COVID-19
Epidemic
Regional medical consortium
