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目的 初步研究 2型糖尿病患者在社区卫生服务机构与三级医院专科之间双向转诊临床路径的应用并对其进行评价。方法 用同期非随机对照试验对开发研制的 2型糖尿病患者双向转诊临床路径进行评价 ,比较就诊情况、转归情况、就诊时间、患者满意度、医疗费用等。对 2 2名 2型糖尿病患者 (试验组 )按照双向转诊临床路径从社区向复兴医院内分泌科病房转诊 ,并在出院后转回社区 ;对照组 2 7例 ,为直接到复兴医院内分泌科就诊的 2型糖尿病患者。结果 出院后试验组患者再次就诊率 2 1 4 % ,低于对照组的 5 9 1% (P <0 0 1) ;试验组糖化血红蛋白 7 3± 1 1,低于对照组的7 9± 0 8(P <0 0 5 ) ;试验组就诊时间 (6± 15 )h ,明显少于对照组 (P <0 0 1) ;患者满意度、医疗费用等试验组均明显好于对照组 (P <0 0 5 )。结论 在社区卫生服务机构与三级医院专科之间实施 2型糖尿病患者的双向转诊有利于缩短患者的就诊时间、减少不必要的服务项目、节约医疗费用、提高治疗效果 ,并使服务具有连续性。
Objective To study and evaluate the clinical application of two-way referral of patients with type 2 diabetes between community health service agencies and tertiary hospital specialties. Methods The non-randomized controlled trials in the same period were used to evaluate the bi-directional clinical pathology of type 2 diabetes mellitus patients. The treatment conditions, outcome, treatment time, patient satisfaction and medical expenses were compared. Twenty-two patients with type 2 diabetes (experimental group) were referred to the Department of Endocrinology of Fuxing Hospital from the community according to the two-way referral clinical pathway and returned to the community after discharge. In the control group, 27 patients were directly referred to the Department of Endocrinology of Fuxing Hospital Treatment of type 2 diabetes. Results After discharge from the hospital, the rate of re-visit was 214% in the test group, which was lower than that in the control group (59.01%) (P <0.01). The HbA1c in the test group was lower than that in the control group (P <0.05). The treatment time in the experimental group (6 ± 15) h was significantly less than that in the control group (P <0.01). The patient satisfaction and medical expenses were significantly higher in the experimental group than in the control group <0 0 5). Conclusion The implementation of two-way referral of patients with type 2 diabetes between community health service agencies and tertiary hospital specialties can shorten the time of visiting patients, reduce unnecessary service items, save medical expenses, improve the treatment effect and make the service continuous Sex.