自我管理干预对慢性阻塞性肺疾病患者医疗资源使用情况的影响  

Effect of the self-management intervention on the medical costs of patients with chronic obstructive pulmonary disease

作　　者：于书慧[1] 郭爱敏[2] 张香娟[3] 

机构地区：[1]北京大学第一医院泌尿外科,100034 [2]北京协和医学院护理学院,100144 [3]卫生部北京医院呼吸内科,100005

出　　处：《中华现代护理杂志》2013年第21期2528-2530,共3页Chinese Journal of Modern Nursing

摘　　要：目的 探讨自我管理干预对慢性阻塞性肺疾病（COpD）患者医疗资源使用情况的影响.方法 选择病情稳定准许出院或门诊就诊的COPD患者84例,按照时间顺序随机分为两组,干预组42例患者接受自我管理干预,对照组42例患者接受常规护理.比较干预3个月和6个月时的两组患者医疗资源使用情况和急性加重次数情况.结果 干预3个月,干预组急诊4例5例次,住院3例5例次,加重12例17例次；对照组急诊人数5例11例次,住院5例8例次,加重27例54例次.干预3个月时,两组患者急诊次数、住院次数和住院天数比较,差异无统计学意义（P＞0.05）,两组患者的急性加重次数比较,差异具有统计学意义（Z=-3.361,P＜0.01）.干预6个月,干预组急诊6例8例次,住院4例6例次,加重18例23例次；对照组急诊人数5例18例次,住院6例9例次,加重27例65例次；两组患者急诊次数、住院次数和住院天数的差异无统计学意义（P＞0.05）,两组患者的急性加重次数的差异有统计学意义（Z=-3.018,P＜0.01）.结论 自我管理干预可以减少患者急性加重次数,但是在减少患者急诊次数、住院次数和住院天数等医疗资源使用方面有待于进一步的研究.Objective To explore the effect of self-management intervention on chronic obstructive pulmonary disease （COPD） patients＇ medical costs.Methods Convenience sampling of 84 COPD patients at stable stage or discharged from hospital after treatment in Beijing Hospital and PUMC Hospital were recruited from April 2011 to January 2012.The samples were divided into two subgroups.Intervention group （n =42）performed self-management intervention,patients in control group （n =42） only received usual care.All patients were followed up and collected regarding times of exacerbations or emergency,times or length of hospitalization at 3 months and 6 months respectively.Results There was significant difference between group at both 3 and 6 months,but no difference in times of emergency,times or length of hospitalization were found between groups.And at the 3th months in intervention group,times of emergency and hospitalization times respectively were （4 cases 5times）and （3cases 5times） and that in control group respectively were （5cases11times）,（5cases 8times）,no significant difference was found between them （P ＞ 0.05）,while significant difference was found in exacerbations times （12cases 17times vs 27cases 54times ;Z =-3.361,P ＜ 0.01）.No significant difference was found at the 6th months between intervention group and control group in times of emergency （6cases 8times vs 5cases18times） and hospitalization times （4cases 6times vs 6cases 9times）,while significant difference was found in exacerbations times （18cases 23times vs 27cases 65times;Z =-3.018,P ＜0.01）.Conclusions Self-management intervention can decrease COPD patients＇ times of exacerbations,and whether can decrease times of emergency,times or length of hospitalization should be study in further.

关 键 词：肺疾病 慢性阻塞性 急性加重 医疗资源使用 自我管理干预 

分 类 号：R473[医药卫生—护理学]