Application of a chain management protocol in patients with chronic refractory wounds under the medical consortium...

Chronic refractory wounds represent a major public health challenge in China, characterized by fragmented and unstandardized services, insufficient continuity of care, and weak inter-institutional collaboration. This study aimed to evaluate the effectiveness of a medical consortium-based chain management protocol for improving health service quality, care continuity, and clinical outcomes in chronic wound management.

This was a health services intervention study conducted at a tertiary hospital in Nanchang. From June 2024 to May 2025, 68 patients with chronic wounds were enrolled using convenience sampling and randomly allocated to intervention (n = 34) or control (n = 34) groups. The control group received conventional care, while the intervention group received a structured chain management protocol including multidisciplinary team (MDT) establishment, standardized care pathways, homogeneous training, and full-cycle coordinated care from hospital treatment to post-discharge linkage with primary care facilities. Outcome measures included Bates-Jensen Wound Assessment Tool scores, wound healing time, referral and consultation efficiency, and patient satisfaction.

Repeated-measures ANOVA showed a significant time-group interaction for Bates-Jensen scores (F = 4.075, p = 0.010). Bates-Jensen scores are reported as median (P25, P75); non-parametric sensitivity analyses confirmed no baseline difference between groups, with the intervention group showing progressively lower scores, most markedly at Week 4 (p < 0.001). Median healing time was 30.5 days in the intervention group versus 52.5 days in the control group (p = 0.001). Patient satisfaction was 97.1% in the intervention group compared with 76.5% in the control group (p = 0.027). The intervention also improved inter-institutional referral and consultation efficiency.

A medical consortium-based chain management protocol effectively optimizes health service organization, strengthens interdisciplinary and inter-institutional collaboration, and improves the continuity, standardization, and efficiency of chronic wound care. This model shortens healing time, enhances patient satisfaction, and provides an implementable and scalable strategy for chronic wound management in the health service system. It offers important implications for public health practice and resource allocation in wound care management.