智慧转诊在体检重大异常结果受检者中的应用效果  

Application effect of intelligent referral in examinees with major abnormal results in physical examinations

作　　者：陈英[1] 谢云彩 黄平平 陈梦雪 陈园园 陈曜[1] Chen Ying;Xie Yuncai;Huang Pingping;Chen Mengxue;Chen Yuanyuan;Chen Yao(Health Medical Center,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 404100,China)

机构地区：[1]重庆医科大学附属第二医院健康医学中心,重庆404100

出　　处：《中华健康管理学杂志》2024年第7期529-534,共6页Chinese Journal of Health Management

摘　　要：目的探讨智慧转诊在体检重大异常结果(即具有重要临床意义的异常检查结果)受检者中的应用效果。方法本研究属于横断面研究,选取2022年1—12月在重庆医科大学附属第二医院健康医学中心体检检出重大异常结果者1104例作为普通转诊组,2023年1—12月检出重大异常结果者1120例作为智慧转诊组。普通转诊组采用以健康医学中心总检医师为主的常规健康宣教,嘱其门诊就诊的普通流程模式。智慧转诊组在普通转诊的基础上采用以由护理人员、专科医师组成的转诊团队基于互联网技术手段,将受检者的病历、检查结果、影像资料等医疗信息进行数字化整合和共享,提供快速就诊绿色通道,协助受检者立即就诊的智慧转诊模式。比较两组重大异常结果受检者在得到异常结果通知后的就诊率、住院率、平均就诊时间、总体满意度。根据阳性结果分为超声检查类、放射影像类、临床检验类、血压类4个亚组,进一步进行组间比较。结果两组人群得到通知后的就诊率(智慧转诊组84.8%,普通转诊组67.2%,χ^(2)=168.4)、住院率(智慧转诊组48.8%,普通转诊组36.5%,χ^(2)=17.80)、平均就诊时间(智慧转诊组116 min,普通流程组301 min,Z=-15.82)、总体满意度得分[智慧转诊组(9.70±0.62)分,普通转诊组(8.29±1.26)分,t=-33.47](均P<0.05)。重大异常结果分类统计提示智慧转诊组超声检查类、放射影像类、临床检验类、血压类各类就诊率均高于普通转诊组(分别为87.9%比70.4%,89.9%比70.6%,80.6%比60.2%,57.2%比41.3%;χ^(2)=41.91、39.37、19.37、6.20,均P<0.05);超声检查类、放射影像类、血压类住院率均高于普通转诊组(66.8%比64.0%,55.7%比42.2%,18.7%比11.2%,χ^(2)=16.86、11.91、8.68,均P<0.05);超声检查类、放射影像类、临床检验类平均就诊时间均低于普通转诊组(96比308 min、110比300 min、122比286 min,Z=-11.38、-9.27、-7.63,均P<0.01);超声检查Objective To explore the application effect of intelligent referral mode in examinees with major positive results in physical examinations in a health medical center.Methods A cross-sectional study was conducted from January 2022 to December 2023 with subjects receiving physical examinations.Those subjects with major positive results from January 2022 to December 2022 in the Health Medical Center of the Second Affiliated Hospital of Chongqing Medical University were selected as the routine referral group,and those with major positive results from January 2023 to December 2023 were selected as the intelligent referral group.The routine referral group received routine health education from the chief inspector in the health medical center,suggesting them to get outpatient consultation.On the basis of ordinary referral,the intelligent referral group received health education from a referral team composed of nurses and specialists based on internet technology to digitally integrate and share patients′medical records,examination results,imaging data and other medical information.The subects in the intelligent referral group were provided with a green channel for outpatient consultation and medical treatment immediately.The visiting rate,hospitalization rate,average visiting time,and overall satisfaction of the subjects after being notified of abnormal results were compared between the two groups.According to the positive results,the subjects were divided into four subgroups:ultrasound examination group,radiology group,clinical laboratory group and blood pressure group.Results After the notification,there were significant differences in hospital visit rate(84.8%vs 67.2%,χ^(2)=168.4),hospitalization rate(48.8%vs 36.5%,χ^(2)=17.80),average visit time(116 min vs 301 min,Z=-15.82),and overall satisfaction score(9.70±0.62 vs 8.29±1.26,t=-33.47)between intelligent referral group and general referral group(all P<0.01).The classification statistics of major abnormal results showed that the consultation rates in subjects w

关 键 词：体格检查 患者转诊 重大异常结果 

分 类 号：R194.3[医药卫生—卫生事业管理]