医联体模式下儿童变应性鼻炎社区诊疗管理与疗效评价  

Community diagnosis and treatment management and efficacy evaluation of allergic rhinitis in children under medical alliances model

作　　者：莫丹丹 包敏 王燕萍 陆萍 唐慧芸 董文芳[2] 陈健德 吴巾红 MO Dandan;BAO Min;WANG Yanping;LU Ping;TANG Huiyun;DONG Wenfang;CHEN Jiande;WU Jinhong(Jinyang Community Health Service Center,Pudong New Area,Shanghai 200136,China;Shanghai Children’s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海市浦东新区金杨社区卫生服务中心,中国上海200136 [2]上海交通大学医学院附属上海儿童医学中心,中国上海200127

出　　处：《教育生物学杂志》2024年第5期375-378,384,共5页Journal of Bio-education

基　　金：儿科医疗联合体(浦东)卫生科教项目(PW2020A-03)。

摘　　要：目的探讨医联体模式下儿童变应性鼻炎的社区诊疗管理效果。方法研究纳入2022年7月—2023年6月在上海儿童医学中心(SCMC组,114例)和金杨社区卫生服务中心(JINYANG组,111例)就诊并诊断为变应性鼻炎的患者,采用标准统一的规范诊疗模式对患儿进行诊治和随访管理。每个月进行1次疗效评估,根据视觉模拟量表(visual analog scale,VAS)和儿童简化版鼻结膜炎生活质量问卷(mini rhinoconjunctivitis quality of life questionnaire,mRQLQ)评分,判断疾病严重程度并调整治疗方案。对2组患者的治疗效果(VAS和mRQLQ评分)以及就诊费用、就诊花费时间、就诊满意度等进行分析和比较。结果随访管理3个月时,2组间VAS评分的差异无统计学意义(P>0.05),JINYANG组mRQLQ评分显著优于SCMC组(P<0.01);与基线数据比较,SCMC组和JINYANG组VAS评分[2(2,3)vs 7(6,8);2(2,3)vs 6(6,7)]和mRQLQ评分[(4.21±1.21)vs(35.31±7.29);(3.64±1.18)vs(37.32±6.82)]均改善显著(P<0.05);SCMC组和JINYANG组单次门诊费用分别平均为(305±29.8)元和(159±21.9)元(P<0.05),单次就诊时间分别平均为3 h和1.5 h,就诊满意度分别为95%和99%。结论儿童变应性鼻炎患者在社区医院进行规范化治疗和管理,能获得与三级医院同质效果,且减少花费、节约就诊时间,并可获得较高的满意度。Objective To investigate the effectiveness of community diagnosis and treatment management of allergic rhinitis in children under the medical alliances model.Methods The study included patients diagnosed with allergic rhinitis who visited Shanghai Children’s Medical Center(SCMC group,114 cases)and Jinyang Community Health Service Center(JINYANG group,111 cases)from July 2022 to June 2023.The patients received standardized diagnosis and treatment model in progress of diagnosis,treatment,and follow-up.Visual analog scale(VAS)and mini rhinoconjunctivitis quality of life questionnaire(mRQLQ)were used monthly to assess disease severity and treatment plans were adjusted subsequently.We analyzed and compared the treatment outcomes(VAS and mRQLQ scores),medical expenses,time spent on medical treatment,and satisfaction with medical treatment between the two groups.Results After 3 months of follow-up management,there was no statistically significant difference in VAS scores between the two groups(P>0.05).The mRQLQ scores in the JINYANG group were significantly better than those in the SCMC group(P<0.01).Compared with baseline data,the VAS scores[2(2,3)vs 7(6,8);2(2,3)vs 6(6,7)]and mRQLQ scores[(4.21±1.21)vs(35.31±7.29);(3.64±1.18)vs(37.32±6.82)]in the SCMC group and the JINYANG group showed significant improvement(P<0.05).The average single outpatient expenses for the SCMC group and the JINYANG group were(305±29.8)yuan and(159±21.9)yuan,respectively(P<0.05).The average single visit duration was 3 h and 1.5 h,respectively,and the satisfaction rates were 95%and 99%,respectively.Conclusion The standardized diagnosis and treatment of allergic rhinitis in community hospitals can achieve similar results as tertiary hospitals,while reducing costs,saving treatment time,and achieving higher patient satisfaction.

关 键 词：变应性鼻炎 社区医院 三级医院 医联体模式 儿童 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]