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慢性肝病社区管理的必要性和可行性分析 被引量:5

A study on the necessity and feasibility of management of chronic liver diseases in community clinic
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摘要 目的:探讨常见慢性肝病社区管理的必要性与可行性。方法查阅北京4家社区卫生服务中心居民健康档案及社区内小型事业单位职工体检结果,并在北京3家三级甲等医院就慢性乙型肝炎(CHB)、脂肪性肝病患者的月均就医费用、对于慢性肝病社区管理的认识及社区医院与三级医院之间合作转诊的态度等问题进行问卷调查,对以上结果进行分析。结果社区中,352例60岁以上老年人脂肪肝的患病率为33.7%~36.9%,其中93.5%的患者血脂升高。在小型事业单位中,脂肪肝的患病率为13.5%,91.2%患者合并血脂异常。共完成调查问卷970份,其中慢性肝病患者800份,社区医师170份。CHB 和脂肪性肝病患者月均花费分别为994.2元和279.3元。57.2%的 CHB 患者和80.9%的脂肪性肝病患者愿意接受社区管理。大约85.6%的患者希望通过社区医师判断患者是否需要转诊至三级医院,98.2%的患者希望由三级医院安排患者回到社区医院就诊。91.4%的城区和96.0%的郊区社区医师愿意参与慢性肝病的管理。结论对 CHB 和脂肪性肝病的社区管理,具备必要性和一定的可行性,应进一步完善社区居民健康档案管理、社区医师专业知识培训以及基本药物制度。 Objective To discuss the necessity and feasibility of community management of common chronic liver diseases. Methods Refer to the residentsˊ health records and staff medical examination results from four community health service centers of Beijing and questionnaires of the monthly medical cost of fatty liver and chronic hepatitis B patients,the understanding of the community management to chronic liver diseases and attitude of referral cooperation between community and tertiary hospitals in 3 first class tertiary hospitals,we analyzed the necessity and feasi-bility of community management of common chronic liver diseases. Results In the community,the prevalence of fatty liver disease was 33. 7% ~36. 9% in 352 old people over 60 years old,93. 5% of the patients with elevated blood lipids. In small units,the prevalence of fatty liver was 13. 5% ,91. 2% of patients with combined dyslipidemia. Completed questionnaire 970,of which 800 with chronic liver disease,178 were community doctors. Patients with CHB and fatty liver disease average monthly cost 994. 2 yuan and 279. 3 yuan respectively. 57. 2% of CHB patients and 80. 9% of fatty liver patients were willing to accept community management. About 85. 6% of the patients proposed that community physicians should determine whether patients need referral to tertiary hospitals,98. 2% of the patients suggested tertiary hospital should make arrangement for retur-ning to the community hospital. 91. 4% of urban and 96. 0% of suburban community physicians had willingness to manage chronic liver disease. Conclusion There was some necessity and feasibility to manage CHB and fatty liver disease in the community. The community residentsˊ health records management,community doctors professional knowledge training and the basic drug system should be further improved.
出处 《临床和实验医学杂志》 2015年第2期143-146,共4页 Journal of Clinical and Experimental Medicine
基金 首都医学发展科研基金项目(编号2011-管-10)
关键词 慢性乙型肝炎 脂肪性肝病 社区管理 Chronic hepatitis B Fatty liver Community management
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