塔吉克斯坦家庭医生和选定专家的患者转诊模式。

Patient referral patterns by family doctors and to selected specialists in Tajikistan.

机构信息

Swiss Center for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.

出版信息

Int Health. 2012 Dec;4(4):268-76. doi: 10.1016/j.inhe.2012.09.003.

DOI:10.1016/j.inhe.2012.09.003

Abstract

Referral rates are a key measure for the functioning of a healthcare system. The objective of this study was to assess referral patterns from family doctors (FD) and selected specialists to other specialists and hospitals in two rayons (districts) of Tajikistan. Quantitative data on referral decisions and self-referral was collected among FDs and selected specialists over a 10-workday period in 2008. For comparison, the collected information was contrasted to routinely recorded data and figures from the national health information system (HIS). The mean referral rate of FDs was 20.0% while the referral rate according to the HIS was 4.5%. In one rayon, the majority of the referred patients were sent to hospitals (65.6%) while in the other rayon, 65.9% were advised to see a specialist. Technical diagnostic tests not available at the primary healthcare level triggered the majority of all referrals. A need for diagnosis and treatment by specialists accounted for 19.2% of the referrals. Self-referral was common among patients seen by ophthalmologists and otorhinolaryngologists (76.0%). We conclude that referral rates among Tajik FD patients are high and self-referral of patients to a specialist is the norm. The routine HIS fails to provide accurate data.

摘要

转诊率是衡量医疗体系运行状况的一个关键指标。本研究的目的是评估塔吉克斯坦两个行政区（rayon）家庭医生（FD）和选定专科医生向其他专科医生和医院转诊的模式。2008 年，FD 和选定专科医生在 10 个工作日内收集了转诊决策和自我转诊的定量数据。为了进行比较，还将收集的信息与国家卫生信息系统（HIS）的常规记录数据和数字进行了对比。FD 的平均转诊率为 20.0%，而 HIS 记录的转诊率为 4.5%。在一个行政区，转诊的患者大多数被送往医院（65.6%），而在另一个行政区，建议 65.9%的患者去看专科医生。基层医疗保健水平无法进行的技术诊断检测导致了大多数转诊。需要专科医生进行诊断和治疗的占所有转诊的 19.2%。眼科医生和耳鼻喉科医生（otorhinolaryngologists）就诊的患者中，自我转诊很常见（76.0%）。我们得出结论，塔吉克斯坦 FD 患者的转诊率很高，患者自我转诊至专科医生处是常态。常规 HIS 无法提供准确的数据。