摘要
Abstract
Objective To study the"tricolor ladder"long-prescription management mode and its effect.Methods The categories of chronic diseases and corresponding drugs of community"tricolor ladder"long-prescription management mode were selected through guided seminars held by Longhua Community Health Service Center and focused discussions of family doctor representatives from 13 community health service centers of Xuhui District in Shanghai.Patients were assigned into files of three different colors: patients who sought medical advice≤1 time/month before management and were prescribed with 10-12 weeks basic medication were assigned to green files; patients who sought medical advice 2-3 times/month before management and were prescribed with 6-8 weeks basic medication were assigned to yellow files; patients who sought medical advice 4-5 times/month before management and were prescribed with 2-4 weeks basic medication were assigned to red files.A total of 987 patients with 9 common chronic diseases who visited doctors in Hengdiyuan Community Health Service Station and Fenggulu Community Health Service Station under Longhua Community Health Service Center from October 1, 2014 to March 31, 2015 were enrolled as subjects.The times of visit, expenses and satisfaction degree of the patients before and after management were recorded.Results Nine common community chronic diseases ( hypertension, coronary heart disease, diabetes, hyperlipemia, osteoporosis, Parkinson′s disease, thyroid disease, hyperuricemia and prostatic hyperplasia) and 59 basic medications available in community were included in the management.From October 1, 2014 to March 31, 2015, a total of 987 patients were included into"tricolor ladder"long-prescription management, including 492 (49.8%) patients with green cards, 405 (41.0%) patients with yellow cards and 90 ( 9.2%) patients with red cards.After management, the times of visits to doctors per person was significantly different from that before management ( P<0.05 ); the average monthly expense of patients with yellow cards and red cards were significantly different from that before management ( P<0.05 ) .The satisfaction degree of patients with green card was 100.0% (20/20); among patients with yellow cards, 17 (85.0%) patients were satisfied, 2 (10.0%) patients were basically satisfied, and 1 (5.0%) patient did not care about it; among patients with red cards, 16 (80.0%) patients were satisfied, 1 ( 5.0%) patient was basically satisfied and 3 ( 15.0%) patients did not care about it.Conclusion The"tricolor ladder"long-prescription management mode lessen the times of visits to doctors of patients and reduce the burden of family doctors′outpatient service, achieving favorable effect and worth being promoted in community, while correspondent assurance policy and software and hardware support are also needed to play its role to the most.关键词
社区卫生服务/长处方/管理模式Key words
Community health services/Long-prescription/Management mode分类
医药卫生
