“全科-专科”分级管理模式对签约2型糖尿病患者干预效果队列研究  

Cohort study on the intervention effect of"general-specialty"grading management model on type 2 diabetes patients

作　　者：戴慧敏[1] 陈瑜[1] 刘伟[2] 吴培红[2] 杜兆辉 Dai Huimin;Chen Yu;Liu Wei;Wu Peihong;Du Zhaohui(Weifang Community Health Service Center of Pudong New Area,Shanghai City,Shanghai 200122;Department of Endocrinology,Renji Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200127;Shanggang Community Health Service Centre of Pudong New Area,Shanghai City,Shanghai 200126)

机构地区：[1]上海市浦东新区潍坊社区卫生服务中心,上海200122 [2]上海交通大学附属仁济医院内分泌科,上海200127 [3]上海市浦东新区上钢社区卫生服务中心,上海200126

出　　处：《中国社区医师》2021年第2期186-188,共3页Chinese Community Doctors

基　　金：浦东新区卫生系统重要薄弱学科(PWZbr2017-07);上海市卫生计生系统优秀学科带头人(2017BR053);上海市浦东新区卫生系统领先人才培养(PWRl2016-03);上海市“医苑新星”青年医学人才培养资助计划[沪卫计人事(2019)72号]。

摘　　要：目的:探讨“全科-专科”分级管理模式对签约2型糖尿病患者的干预效果。方法:上海交通大学医学院附属仁济医院联合四个社区,开设了糖尿病专病工作室,明确了糖尿病的分级诊疗标准和转诊流程,建立了2型糖尿病“全科-专科”分级管理模式。选取四个社区的糖尿病患者400例,随机分为对照组和试验组,各200例。试验组采用“全科-专科”分级管理模式;对照组采用常规管理。比较两组患者干预前后体征及生化指标水平。结果:试验组干预后舒张压、体重指数(BMI)、空腹血糖、糖化血红蛋白及总胆固醇等指标水平均低于对照组,差异有统计学意义(P<0.05)。结论:“全科-专科”分级管理模式可协调社区全科医生和三级医院专科医生的分工合作,体现了以患者为中心,改善了糖尿病患者的糖代谢水平。Objective:To explore the intervention effect of"general-specialty"grading management model on type 2 diabetes patients.Methods:Renji hospital affiliated to medical college of Shanghai jiaotong university opened a special diabetes studio in four communities,clarified the grading diagnosis and treatment standards and referral process of diabetes,established"general-specialty"grading management model on type 2 diabetes.Four communities of 400 diabetic patients were enrolled,they were randomly divided into two groups with 200 cases in each group.The experimental group adopted"general-specialty"grading management model,while the control group adopted conventional management.Physical signs and biochemical indexes before and after intervention were compared between two groups.Results:After intervention,the levels of diastolic blood pressure,BMI,fasting blood glucose,glycosylated hemoglobin and total cholesterol in experimental group were lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:The"general-specialty"grading management model can coordinate the division of labor and cooperation between community general practitioners and tertiary hospital specialists,which reflects the patient-centered and improves the level of glucose metabolism in diabetic patients.

关 键 词：分级诊疗 全科-专科 2型糖尿病 

分 类 号：R473.2[医药卫生—护理学]