Philbin E F
Section of Heart Failure and Cardiac Transplantation, Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Mich 48202, USA.
J Gen Intern Med. 1999 Feb;14(2):130-5. doi: 10.1046/j.1525-1497.1999.00291.x.
To evaluate the impact of comprehensive, multidisciplinary management programs on the process of care, resource utilization, health care costs, and clinical outcomes in patients with congestive heart failure.
A MEDLINE search identified seven english-language reports that compared the process of care, clinical outcomes, or economic variables related to implementation of a multidisciplinary congestive heart failure management program of at least 3 month's duration to a control or reference group. The primary intent of the programs was to emphasize compliance with recommended therapeutic principles, enhance patient education, and provide careful patient surveillance. Five of the studies reported improved functional status, aerobic capacity, or patient satisfaction. Six of the studies reported a 50% to 85% reduction in the risk of hospital admission. Three studies reported economic analyses with suggestive but not compelling evidence of financial benefit.
Comprehensive, multidisciplinary management programs for congestive heart failure can improve functional status and reduce the risk of hospital admission, and they may lower medical costs.
评估综合多学科管理方案对充血性心力衰竭患者的护理过程、资源利用、医疗保健成本及临床结局的影响。
通过对MEDLINE数据库进行检索，共识别出7篇英文报告，这些报告比较了与实施至少为期3个月的多学科充血性心力衰竭管理方案相关的护理过程、临床结局或经济变量，并与对照组或参照组进行了对比。这些方案的主要目的是强调遵循推荐的治疗原则、加强患者教育并对患者进行密切监测。其中5项研究报告称患者的功能状态、有氧运动能力或满意度有所改善。6项研究报告称住院风险降低了50%至85%。3项研究报告了经济分析结果，有证据表明存在经济效益，但说服力不足。
针对充血性心力衰竭的综合多学科管理方案可改善功能状态、降低住院风险，且可能降低医疗成本。
