摘要
【摘要】目的探讨区域医疗联合体（简称医联体）共管COPD分级诊疗模式对COPD患者的影响。方法以2015年1月1日至2015年12月31日在北京市东城区新中街辖区内收集的COPD患者34例为对照组；以2016年1月1日至2016年12月31日在该辖区收集的COPD患者53例为试验组，对试验组实行医联体共管分级诊疗。对比分析两组的（COPD assessment test，CAT）评分、FEV，％pred、年急性发作次数、年度医疗费用。结果研究前2组患者CAT评分、FEV1％pred及气流受限程度分布差异均无统计学意义（P〉0．05）。随访1年后试验组CAT评分低于对照组（P〈0．05）；试验组FEV1％pred明显高于对照组（P〈0．05）。试验组年急性发作次数、年医疗费用均明显低于对照组（P〈0．05）。分层分析显示试验组门诊维持治疗费用低于对照组（P〈0．05），住院治疗费用2组差异无统计学意义（P〉0．05）。年急性加重门诊、急诊就诊率2组差异无统计学意义（P〉0．05）。亚组分析显示两组住院患者血气分析PO2、PCO2及FEV1％pred比较差异无统计学意义（P〉0．05）。结论医联体共管分级诊疗能明显提高COPD患者的生活质量，改善气流受限程度，减低疾病风险及医疗费用。
Objective To discuss the effect of hierarchical diagnosis model of chronic obstructive pulmonary disease（COPD） by co-management of health alliance on COPD patient. Methods From January 1,2015 to December 31, 2015, 34 patients with COPD in new pages of dongcheng district of Beijing were as control group; 53 patients with COPD were as experiment group, which was given hierarchical diagnosis by co-management of health alliance. Comparative analysis of two groups of COPD assessment test （CAT） score, the percentage of pulmonary function FEV1 accounting for expected value （FEV1%pred）, annual acute episodes and annual medical costs were conducted. Results Before the study the CAT scores, degree of FEV1% pred and limited airflow distribution in two groups of patients show no obvious difference （ P〉0.05）. After 1 year follow-up the CAT score of experiment group is lower than that of control group（ P 〈0.05） ;the FEV1% pred for the experimental group is significantly higher than the control group （ P 〈0.05）.For the experiment group the number of acute attack and annual medical costs are significantly lower than that of the control group （ P 〈0.05）. Hierarchical analysis shows that the outpatient expense of maintenance treatment of the experiment group is lower than that of the control group （ P 〈0.05 The annual acute ） ; the hospitalization expenses between the two groups show no difference exacerbation 0.05）. Subgroup analysis showes groups of hospitalized patients exh co-management of health alliance emergency-dep that the blood artment visits are similar between the two g ga ibit no difference can significantly s analysis of PO2 （ P〈0.05）. Concl PCO2 and FEVt usions hierarchical improve the quality of life in patients obstructive pulmonary disease, improve airflow limited degree, and reduce the risk of diseases and medical cost.
出处
《国际呼吸杂志》
2017年第14期1083-1086,共4页
International Journal of Respiration
关键词
医联体共管
慢性阻塞性肺疾病
分级诊疗
效果分析
Co management of health alliance
Chronic obstructive pulmonary disease
Hierarchicaldiagnosis
Effect analysis
