医联体分级诊疗管理模式对全科医师慢性阻塞性肺疾病的认知影响  

Influence of the management mode of graded diagnosis and treatment of medical conjoined body on general practitioners’ cognition of chronic obstructive pulmonary disease

作　　者：朱惠仙[1] 贺明[1] 严妍 ZHU Huixian;HE Ming;YAN Yan(Medical Department of Xujiahui Community Health Service Center of Xuhui District,Shanghai 200030,China)

机构地区：[1]上海市徐汇区徐家汇街道社区卫生服务中心医务科

出　　处：《上海医药》2019年第12期9-11,59,共4页Shanghai Medical & Pharmaceutical Journal

基　　金：上海市徐汇区尖峰高峰高原学科建设项目(SHXH201724)

摘　　要：目的:分析医疗联合体分级诊疗管理模式对全科医师慢性阻塞性肺疾病认知的影响,为在社区开展慢性阻塞性肺疾病的预防和控制提供参考依据。方法:于2017年6月采取单纯随机抽样方法抽取上海市徐汇区徐家汇街道社区卫生服务中心的44名全科医师纳入调查,对被调查的全科医师进行问卷调查。组织医联体内二、三级医院呼吸科医疗专家每月一次到徐家汇街道社区卫生服务中心进行现场授课,同时在徐家汇街道社区卫生服务中心开设专家门诊。培训后于2018年6月对参与培训的44名全科医师再次进行问卷调查,评估项目、调查方法及评判标准与培训前一致。结果:实施培训后,全科医师对慢性阻塞性肺疾病的认知水平有了显著提升,与培训前比较,其差异有统计学意义(P <0.05)。多因素非条件Logistic回归分析显示,年龄和文化程度是培训后全科医师对慢性阻塞性肺疾病相关知识知晓率的影响因素(P <0.05)。讨论:医疗联合体分级诊疗管理模式能有效提升全科医师对慢性阻塞性肺疾病的治疗及指导康复能力。Objective: To analyze the influence of the management mode of graded diagnosis and treatment of medical conjoined body on general practitioners’ cognition of chronic obstructive pulmonary disease(COPD) for providing reference for the prevention and control of chronic obstructive pulmonary disease in the community. Methods: In June 2017, 44 general practitioners from Xujiahui Community Health Service Center in Xuhui District of Shanghai were selected by simple random sampling, and questionnaires were sent out to the general practitioners in the field. The medical experts of the second-and thirdlevel hospitals in medical conjoined body were organized to go to the Xujiahui Community Health Service Center to give onsite lectures once a month, and at the same time, an expert clinic was opened at Xujiahui Community Health Service Center.After the training, 44 general practitioners who participated in the training were re-questioned in June 2018, and the assessment project, survey method and evaluation criteria were consistent with those before the training. Results: After implementation of the training, the general practitioner’s cognitive level of chronic obstructive pulmonary disease had been significantly improved.Compared with the pre-training, the difference was statistically significant(P<0.05). Multivariate unconditional logistic regression analysis showed that age and education level were the influencing factors of awareness rate of knowledge related to COPD of general practitioners after training(P<0.05). Conclusion: The management mode of graded diagnosis and treatment of medical conjoined body can effectively improve the general practitioner’s ability to treat COPD and guide rehabilitation.

关 键 词：医联体分级诊疗管理模式 慢性阻塞性肺疾病 全科医师 

分 类 号：R197.3[医药卫生—卫生事业管理] R563[医药卫生—公共卫生与预防医学]