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基于人口的系统自动化监测,以改善原发性皮肤黑色素瘤的结果

Allison Ching¹, Kathryn Pedula², Theresa Devere²

¹Kaiser Permanente Hawaii, Honolulu, HI, USA.

Journal of primary care & community health

|December 16, 2024

概括

针对黑色素瘤患者的系统自动化计划显著改善了随访遵守和早期检测第二原发性黑色素瘤 (SPMs). 这导致死亡率降低,提高了患者安全和护理效率.

科学领域:

皮肤病学皮肤病学
在瘤学瘤学.
公共卫生监督公共卫生监督

背景情况:

患有原发性皮肤黑色素瘤 (PCM) 的患者面临患第二种原发性黑色素瘤 (SPM) 的风险增加.
较低的推后续护理遵守率和高的患者退学率阻碍了对SPM的有效监测.
现有的基于人口的SPM监测策略缺乏全面的描述.

研究的目的:

评估PCM患者全身皮肤检查 (TBSE) 的系统自动化基于人口的程序 (SAPP) 是否改善了随访遵守.
为了确定SAPP是否提高了SPM的检测,并与自动化前期和数据库前期相比影响了死亡率.

主要方法:

在一个大型综合医疗保健系统中进行了一项质量改进研究.
包括6317名PCM患者在三个时期:数据库前 (2005-2009),自动化前 (2009-2015) 和自动化后 (2015-2021).
干预涉及手动注册 (自动化前) 和系统自动化程序 (自动化后),以确保皮肤科医生TBSE.

主要成果:

在早期和晚期PCM患者中,SAPP显著减少了TBSE之间的中位时间 (P < .0001).
在研究期间,每人每年的TBSE数量在研究期间增加,在自动化后阶段显著增加 (P < .0001).
SPM检测率有所改善,SPM在早期阶段被诊断出来 (P< .0001为趋势),同时所有原因和黑色素瘤特异性死亡率显著降低.

结论:

对皮肤科医生TBSE实施一个系统的,基于人口的自动化程序,可以提高PCM患者的后续遵守.
该计划导致了每年增加的TBSE,更早的SPM检测,以及持续的改善,包括显著降低死亡率.
这种自动化系统提供了一个优先考虑高风险患者的策略,提高了患者的安全性,护理效率和及时性.

关键词:

这是皮肤黑色素瘤.黑色素瘤是一种黑色素瘤.查检查查检查查检查查检查第二种原发性黑色素瘤监控监督监督监督监督监督监督监督监督监督监督监督监督监督监督监督监督监督全身皮肤检查全身皮肤检查

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