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目的探索双向转诊医疗风险控制量表模型(以下简称:模型)对社区卫生服务临床工作中医疗风险控制的预测效果。方法将来我中心就诊的需要住院治疗的患者按简单随机法随机分为两组,使用模型软件进行评估预测后,决定转诊或住院者为观察组,使用传统临床经验法判定其转诊或住院者为对照组,对两组患者进行全程前瞻性临床观察,并对其转诊率、同病种平均住院天数等指标进行综合分析,判定其医疗卫生服务效果情况。结果模型观察组转诊率、同病种平均住院天数、平均住院费用等均低于传统对照组,患者满意率在对向上转诊工作流程、对社区医生服务态度、对社区护士服务态度、对社区卫生诊治水平等方面高于传统对照组。结论本模型能实时计算预警值,提醒临床医生及时发现问题,对暴露或反映医疗风险的问题快速做出回应,并使医生工作流程变得直观、简便、务实、安全及高效,促使医生规范操作流程,提高医疗技术。进一步完善双向转诊“大病重病到医院,小病康复入社区”的目标,有望达到双向转诊医疗机构与社保部门的统一。
Objective To explore the predictive effect of two-way referral medical risk control scale model (hereinafter referred to as the model) on the control of medical risk in the clinical work of community health services. Methods In the future, patients who needed hospitalization in our center were randomly divided into two groups according to the simple randomized method. After the model software was used to evaluate the prognosis, the referral or inpatient was decided as the observation group, and the traditional clinical experience was used to judge the referral or inpatient As the control group, the two groups of patients were prospective clinical observation, and the referral rate, with the average number of hospital days and other indicators of a comprehensive analysis to determine the effect of medical and health services. Results The referral rate of the model observation group, the average length of stay in the same type of disease and the average hospitalization cost were all lower than those in the traditional control group. The patient satisfaction rate was in the referral workflow, the attitude to the community doctor and the attitude to the community nurses, Community health diagnosis and treatment level is higher than the traditional control group. Conclusion This model can calculate early warning value in real time, remind clinicians to discover problems in time, respond quickly to the problems of exposing or reflecting medical risks, and make doctors’ workflow intuitive, simple, pragmatic, safe and efficient, prompting doctors to standardize the operation Process, improve medical technology. Further improve the two-way referral “serious illness and serious illness to the hospital, ailments rehabilitated community ” goal, is expected to reach the two-way referral medical institutions and social security departments.