Olivarius N D, Lauritzen T, Beck-Nielsen H, Fog J, Mogensen C E
Central Research Unit of General Practice, Panum Institute, Copenhagen, Denmark.
Diabet Med. 1994 Jan-Feb;11(1):123-5. doi: 10.1111/j.1464-5491.1994.tb00243.x.
In Denmark the co-operation between the primary and secondary health care system is organized through referrals. Recommendations for improving interaction between the diabetes team (diabetologists, diabetes nurses, dietitians, chiropodists etc.) at the diabetes clinic, and general practice have been prepared by a working party for the Danish National Board of Health. General recommendations: (a) Appointment of a liaison committee in each county consisting of general practitioners (GPs), diabetologists, administrators, etc. (b) Employment of a GP at the diabetes clinic to take care of improving communication, teaching, research, quality assessment, etc. (c) Referral of all newly diagnosed patients with Type 1 diabetes and younger or complicated patients with Type 2 diabetes to the diabetes clinic. More far-reaching forms of co-operation to be discussed in the liaison committees include: (a) Based upon his own knowledge of where to look for help to solve a specific health problem, the diabetic patient may on his own initiative consult either the diabetes clinic or general practice. (b) Provision of access to consult the diabetes nurse/dietitian at the diabetes clinic for instruction without a formal referral. (c) Patients treated solely in general practice and thus unknown to the diabetes clinic may be referred or reported systematically to the diabetes clinic.
在丹麦，初级卫生保健系统与二级卫生保健系统之间的合作是通过转诊来组织的。丹麦国家卫生局的一个工作小组已制定了改善糖尿病诊所的糖尿病团队（糖尿病专家、糖尿病护士、营养师、足病医生等）与全科医疗之间互动的建议。一般建议：(a) 在每个县任命一个由全科医生、糖尿病专家、管理人员等组成的联络委员会。(b) 在糖尿病诊所雇用一名全科医生，负责改善沟通、教学、研究、质量评估等工作。(c) 将所有新诊断的1型糖尿病患者以及年龄较小或患有复杂2型糖尿病的患者转诊至糖尿病诊所。联络委员会将讨论的更广泛的合作形式包括：(a) 根据糖尿病患者自身对何处寻求帮助以解决特定健康问题的了解，患者可主动咨询糖尿病诊所或全科医疗。(b) 提供在无需正式转诊的情况下咨询糖尿病诊所的糖尿病护士/营养师以获取指导的途径。(c) 仅在全科医疗接受治疗且糖尿病诊所不了解的患者，可被系统地转诊或报告至糖尿病诊所。
