中国全科医学2017，Vol.20Issue(3)：251-261,11.DOI:10.3969/j.issn.1007-9572.2017.03.001
中国成人动脉粥样硬化性心血管疾病基层管理路径专家共识（建议稿）
Expert Consensus on the Clinical Pathways for the Atherosclerotic Cardiovascular Disease Management in Primary Care in Chinese Adults(Proposed Edition)
摘要
Abstract
This Expert Consensus on the Management Modes for Atherosclerotic Cardiovascular Disease in Chinese Adults in Primary Care( Proposed Draft)〔hereinafter referred to as the Expert Consensus( Proposed Draft)〕was developed by the Academic Group of Chronic Disease Management,The Society of General Practice,Chinese Medical Association,in order to further regulate the medical management of cardiovascular diseases of general practitioners( GPs)and their team in primary care, to improve service quality and the utilization efficiency of medical resources,and to reduce the risk and cost of health care so that patients can get access to appropriate and high ―quality primary health care. In accordance with the basic requirements of the national profession standard of Development and implementation of clinical pathways for medical institutions(WS/T393―2012), the Expert Consensus ( Proposed Draft ) provides scientific and standardized management pathways of atherosclerotic cardiovascular disease( ASCVD)for GPs and their team in primary care,which is guided by the principles of person―centered care,evidence―based medicine,standardization and normalization,continuous improvement and data ―based analysis. The Expert Consensus( Proposed Draft)mainly includes applicable subjects,diagnostic evidence,referral criteria,ASCVD risk assessment,major inspection items,scientific basis for the development of management plan for ASCVD,management plan for ASCVD,the control targets for the main risk factors of ASCVD,variation of management pathways and its causes along with the specific implementation flow chart, pathways form, and medical interview process. This Expert Consensus ( Proposed Draft ) focuses on meeting the composite target objectives of multiple cardiovascular risk factors for ASCVD, pays attention to applicability and feasibility, emphasizes the effectiveness of doctor ― patient interaction, standardizes the management process. Important significance of the development of this Expert Consensus( Proposed Draft)would help to further promote the establishment of a new person ―centered service model,improve the quality and efficiency of disease management in primary care,promote contracted family doctor services,facilitate the establishment of a hierarchical medical system and the construction of " Healthy China" .关键词
动脉粥样硬化/心血管疾病/危险因素/疾病管理/全科医学/专家共识/临床路径Key words
Atherosclerosis/Cardiovascular diseases/Risk factors/Disease management/General practice/Expert consensus/Clinical pathways分类
医药卫生引用本文复制引用
中华医学会全科医学分会慢病管理专业学组..中国成人动脉粥样硬化性心血管疾病基层管理路径专家共识（建议稿）[J].中国全科医学,2017,20(3):251-261,11.基金项目
国家自然科学基金资助项目（71273279）---基于全科医生连续性服务的整合式健康管理服务模式的研究；辽宁省科技计划项目（2013225089）---基于全科医生签约服务的代谢综合征临床管理整合模式研究；沈阳市科学技术计划项目（ F13-220-9-62）---社区代谢综合征患者临床管理适宜技术规范化研究 （）
