Objective To explore the role of general practice department of a general grade A tertiary hospital in bidirectional referrals. Methods Through the electronic medical record system of the Information Center, The Second Hospital of Hebei Medical University, we collected the medical record data of outpatients and inpatients managed by General Practice Department from 2014 to 2016, and conducted an analysis focusing on these outpatients' destination, and inpatients' source and destination. Results From 2014 to 2016, the annual number of outpatient visits were 12 871, 25 714, 31 583, respectively, totaling 70 168. In 2016, the proportion of outpatients transferred to the general ward was 3.63% (1 145/31 583), which was lower compared to 2014 and 2015 (P<0.017);the proportion of outpatients transferred to specialized outpatient clinics and specialized wards was 6.80% (2 145/31 583) and 7.07% (2 234/31 583), both were higher compared with 2014 and 2015 (P<0.017). During 2014—2016, the number of annual inpatient visits were 1 858, 2 189, 2 338, respectively, totaling 6 385 visits. In 2016, the proportion of inpatients transferred from the grassroots medical institutions, and from specialized outpatient clinics and wards was 81.01% (1 894/2 338) and 51.03% (1 193/2 338), both were higher compared with 2014 and 2015 (P<0.017);the proportion of inpatients transferred to the specialized wards and to the grassroots medical institutions was 22.97% (537/2 338) and 36.01% (842/2 338), both were higher compared with 2014 and 2015 (P<0.017). Conclusion The general practice department of the general grade A tertiary hospital closely cooperates with intra-hospital specialized outpatient clinics and wards and grassroots medical institutions, indicating its role as a bridge and link is increasing in the cooperation and bidirectional referrals between medical treatment units at all levels.%目的 探讨综合性三级甲等医院全科医学科在双向转诊中的作用.方法 通过河北医科大学第二医院信息中心的电子病历系统,收集2014—2016年全科医疗科门诊和病房住院患者的病历信息,重点对门诊患者的去向、住院患者的来源和去向进行分析.结果 共有全科医学科门诊患者70168人次,2014—2016年分别为12871、25714、31583人次.2016年门诊患者转入全科病房的比例为3.63%(1145/31583),低于2014、2015年,差异有统计学意义(P<0.017);2016年门诊患者转入专科门诊、专科病房的比例分别为6.80%(2145/31583)、7.07% (2234/31583),高于2014、2015年,差异有统计学意义(P<0.017).共收治住院患者6385人次,2014—2016年分别为1858、2189、2338人次.2016年住院患者由基层医疗单位转入、由专科转入的比例分别为81.01%(1894/2338)、51.03%(1193/2338),高于2014、2015年,差异有统计学意义(P<0.017);2016年住院患者转入专科病房、下转至基层医疗单位的比例分别为22.97%(537/2338)、36.01%(842/2338),高于2014、2015年,差异有统计学意义(P<0.017).结论 综合性三级甲等医院全科医学科与院内专科和基层医疗单位间的联系密切,其在双向转诊中的地位逐渐突显,是实现上下联动、双向转诊的"桥梁"和"纽带".
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