改善慢性病患者的初级保健:慢性护理模式,第二部分
Thomas Bodenheimer1, Edward H Wagner, Kevin Grumbach
1Family and Community Medicine, University of California, San Francisco, USA. Bodenheimer@Medsch.ucsf.edu
JAMA
|October 17, 2002
概括
慢性护理模式改善了慢性疾病管理,如糖尿病护理,并可以降低医疗保健成本. 然而,广泛采用面临着重大障碍.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 慢性疾病管理 慢性疾病管理
背景情况:
- 慢性疾病对医疗保健系统构成重大负担.
- 有效的管理策略对于改善患者的治疗结果和控制成本至关重要.
研究的目的:
- 审查慢性护理模式在治疗慢性病的有效性方面的证据,以糖尿病为主要例子.
- 评估慢性护理模式对医疗保健成本的影响.
主要方法:
- 对评估慢性护理模式干预措施的研究研究进行系统审查.
- 对研究的分析,重点是慢性疾病的过程和结果测量.
- 检查相关研究中的成本效益数据.
主要成果:
- 在39项研究中,32项显示使用慢性护理模型干预措施改善了糖尿病患者的过程或结果.
- 在27项研究中,有18项研究表明,心力衰竭,喘和糖尿病等疾病的医疗保健成本或服务利用率降低.
- 慢性护理模型显示了提高护理质量和降低开支的潜力.
结论:
- 慢性护理模式在改善慢性疾病管理方面是有效的,并有可能降低医疗保健成本.
- 尽管有证明的好处,但一些障碍阻碍了慢性护理模式的广泛实施.
- 需要进一步的研究和战略规划来克服采用挑战.
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