摘要
目的建立一套科学的哮喘规范诊治评估体系,着力于规范基层医院哮喘诊治技术。方法依据2008版《支气管哮喘防治指南》,制定哮喘规范诊治评估体系,评估随机抽取的5家基层医院(3家二甲和2家三甲)确诊为"支气管哮喘"的病历各50份;根据评估结果进行目标导向性培训,然后按同样方法抽取病例,用同一套评估体系进行再评分。结果初次评分,2家三甲和3家二甲综合评分分别为(74.70±3.47)分和(58.12±5.35)分,2家三甲的诊断指标评分、治疗指标评分及综合评分均明显高于3家二甲(P<0.01);经培训后2家三甲和3家二甲的综合评分分别为(84.35±4.74)分和(73.32±5.65)分,2家三甲的相关指标评分均仍明显高于3家二甲(P<0.05);5家基层医院在目标导向培训后的相关指标评分均较培训前有较大提高(P<0.01)。结论哮喘规范诊治评估体系可有效评估基层医院哮喘诊治水平;使基层医师在哮喘诊治实践中有据可依,有助于推动《指南》在基层的进一步普及。
Objective To establish a set of scientific evaluation system for assessing the skills of diagnosis and treatment on asthma in basic hospitals , which were aimed at promoting the establishment of standardized diagnosis and treatment on asthma.Methods 50medical records of patients diagnosed with asthma were randomly collected from each of three Grade 2Aand two Grade 3Abasic hospitals.Evaluate the medical cases with standardized system which was established according to 《 Guidelines for Prevention and Treatment on Bronchial Asthma 》 2008edition.By analyzing the results , agoal-oriented education programs aimed at solving the practical problems and shortening the gap between practice and guideline was designed and carried out.When the education was finished , another assessment with the same evaluation system was carried out by randomly collecting 50medical records on asthma in each hospital. Then observe the improvement after intervention.Results Before the intervention , the total scores of two Grade 3As and three Grade 2As were ( 74.70±3.4 ) and ( 58.12±5.35 ), respectively ; after the intervention , the total scores were ( 84.35±4.74 ) and ( 73.32±5.65 ), respectively.Both before and after intervention , the diagnosis index , treatment index and total index of two Grade 3As were significantly higher than those of three Grade 2As , respectively ( P <0.01 , P <0.05 ) .The skills of diagnosis and treatment on asthma of the five basic hospitals were greatly improved after intervention ( P <0.01 ) .Conclusions The evaluation system can be efficiently used for assessing the skills of diagnosis and treatment on asthma in basic hospitals , which can be also served as an assistant for putting the 《 Guidelines 》 into practice in basic hospitals.
出处
《中华哮喘杂志（电子版）》
CAS
2013年第2期112-114,共3页
Chinese Journal of Asthma(Electronic Version)
基金
重庆市卫生局医学科研项目(面上项目)(2011-2-10)
重庆市科技攻关计划项目(cstc2012gg-yyjsB10004)
国家临床重点专科专项经费资助
