摘要
目的探讨医联体模式下糖尿病分级管理在慢性病分级诊疗模式中的实施对策及应用效果。方法选取2018年10月至2019年3月的240例糖尿病患者,根据入院时间分为对照组(n=120)和研究组(n=120)。对照组给予自由诊疗模式,研究组给予医联体模式下糖尿病分级管理的慢性病分级诊疗模式,均随访3个月。比较两组转诊情况、血糖控制情况(餐后2 h血糖、空腹血糖及糖化血红蛋白达标率)、随访期间住院次数、诊疗支付费用、对诊疗模式的满意度。结果研究组转至基层诊疗率(46.67%)高于对照组(21.67%),原医院诊疗率(33.33%)低于对照组(65.00%)(P<0.05);随访1个月、3个月,两组餐后2 h血糖、空腹血糖水平均低于入院时,糖化血红蛋白达标率均高于入院时,各时间段两组间餐后2 h血糖、空腹血糖、糖化血红蛋白达标率差异均无统计学意义(P>0.05);研究组诊疗支付费用低于对照组(P<0.05);研究组对诊疗模式满意度(95.00%)高于对照组(80.00%)(P<0.05)。结论医联体模式下糖尿病分级管理在慢性病分级诊疗模式中的实施效果好,具有可行性,有助于改善医疗资源利用情况,减少患者不必要开支,具有较高应用价值。
Objective To explore the implementation countermeasures and application effects of graded management of diabetes mellitus in graded diagnosis and treatment of chronic diseases under the medical conjoint mode.Methods A total of 240 patients with diabetes mellitus from October 2018 to March 2019 were selected and divided into control group(n=120)and study group(n=120)according to different filing time.The control group was given a free diagnosis and treatment model,and the study group was given a chronic disease classification diagnosis and treatment model under the diabetes mellitus classification management model,and all were followed up for 3 months.The referral status,blood glucose control(2 h postprandial blood glucose,fasting blood glucose and glycated hemoglobin compliance rate),the number of hospitalizations during the follow-up,the payment for diagnosis and treatment,and satisfaction with the diagnosis and treatment mode were compared between the two groups.Results The rate of diagnosis and treatment at the grassroots level in the study group(46.67%)was higher than that in the control group(21.67%),and the rate of diagnosis and treatment in the original hospital(33.33%)was lower than that in the control group(65.00%)(P<0.05).Followed up for 1 month and 3 months,the 2 h postprandial blood glucose and fasting blood glucose levels of the two groups were lower than those on admission,and the glycated hemoglobin compliance rate was higher than that on admission.There was no significant difference in the 2 h postprandial blood glucose,fasting blood glucose,and glycated hemoglobin compliance rate between the two groups in each time period(P>0.05).The payment for diagnosis and treatment in the study group was lower than that in the control group(P<0.05).The satisfaction of the study group with the diagnosis and treatment model(95.00%)was higher than that in the control group(80.00%)(P<0.05).Conclusion Under the medical consortium model,the implementation of diabetes mellitus classification management in the chronic disease classification diagnosis and treatment model has good effect and high feasibility.It can help improve the utilization of medical resources and reduce unnecessary expenses for patients,and it has high application value.
作者
曾杉
夏芳
王斌
ZENG Shan;XIA Fang;WANG Bin(Department of Endocrinology,Beilun District,the First Hospital of Zhejiang University,Beilun District People's Hospital,Ningbo 315800,China)
出处
《护理管理杂志》
2021年第7期520-524,共5页
Journal of Nursing Administration
基金
宁波市科技计划项目(2018A10061)。
关键词
糖尿病
分级管理
分级诊疗模式
护理管理
diabetes mellitus
graded management
graded diagnosis and treatment model
nursing management
