摘要
分级诊疗制度被认为是破解我国“看病难、看病贵”问题的治本之策,是全面深化医药卫生体制改革的关键举措,基层医疗机构是实施分级诊疗制度的重要阵地。2型糖尿病是最常见的慢性病之一,其主要危害是微血管和大血管并发症。心血管疾病已成为导致糖尿病患者死亡/致残的主要原因。我国基层医疗机构仍存在医疗技术力量和优质资源不足、综合管理意识与能力相对较低、上下级医疗机构职责不清、双向转诊机制不完善等问题。为适应糖尿病患病率迅猛增长的医疗需求,全面提升基层全科医生“医防融合、全程同质”管理糖尿病的能力,有效开展糖尿病及其并发症的筛查与诊断、患者健康教育和分层管理工作,基层全科医生糖尿病管理能力培训、考核定级与分级授权等工作亟待规范与加强。为此,中国研究型医院学会糖尿病学专业委员会分级诊疗与基层管理糖尿病学组以患者为中心,结合糖尿病管理的最新权威指南和基层诊疗实践,制定了《2型糖尿病分级诊疗与质量管理专家共识》(以下简称共识)。共识力求突出科学性、实用性和可及性,将科学证据与基层实践相结合,以规范基层诊疗行为,提高基层诊疗能力,使基层全科医生真正做好居民健康的“守门人”。
The hierarchical medical system is regarded as the fundamental solution to the problem of"difficulty and high cost of medical treatment"in China,and a key measure to comprehensively deepen the reform of the medical and health system.The primary medical institution is an important position to implement the hierarchical medical system.Type 2 diabetes mellitus is one of the most common chronic diseases,and its main hazards are the microvascular and macrovascular complications.Cardiovascular disease has become a major cause of death or disability in patients with diabetes mellitus.There are still some problems in China's primary medical institutions,such as insufficient medical technology and quality resources,relatively low awareness and ability of comprehensive management,unclear responsibilities of superior and subordinate medical institutions,and imperfect two-way referral mechanism.In order to meet the medical needs of diabetes prevalence of rapid growth,comprehensively enhance the ability of grassroots general practitioners with the integration of medicine and prevention and the whole process of homogeneity to manage diabetes,effectively carry out the screening and diagnosis of diabetes and its complications,patient health education and hierarchical management,the training of diabetes management ability,assessment,grading and authorization of grassroots general practitioners need to be standardized and strengthened.For this reason,the consensus drafting experts committee has formulated the"Experts consensus on the grading medical care and quality management of type 2 diabetes mellitus"(hereinafter referred to as the consensus).The consensus strives to highlight rationale,practicality and accessibility,and combines scientific evidence with rural and community medical practice,expecting to standardize diabetes diagnosis and treatment,improve diabetes management skills,and eventually make rural and community general practitioners be able to serve as reliable"gatekeepers"for public's health.
出处
《中国医学前沿杂志（电子版）》
2020年第5期38-53,共16页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
深圳市卫生健康委员会医防融合代谢病项目组项目(深卫健体改[2019]25号)。
关键词
2型糖尿病
疾病管理
分级诊疗
医院
基层
全科医生
指南
Type 2 diabetes mellitus
Disease management
Grading medical care
Hospital
Rural and community
General practitioner
Guideline
