Department of Medicine, Loyola University Health System, 2160 S First Ave, Bldg 54, 007, Maywood, IL 60153, USA.
J Natl Med Assoc. 2010 Nov;102(11):1009-16. doi: 10.1016/s0027-9684(15)30727-6.
Care for adults with sickle cell disease (SCD) is often fragmented and costly. The chronic care model is recommended as a best practice approach to providing care for patients with chronic disease. However, no published reports exist examining the effectiveness of this approach in adults with SCD.
To examine selected quality and utilization measures at baseline and following implementation of a new multidisciplinary program for adults with SCD at one academic institution.
Administrative data were obtained for all adults with SCD admitted to the adult emergency department or hospital or seen in the adult outpatient clinic during calendar years 2000-2009. Charts of all patients seen in the adult multidisciplinary sickle cell clinic were abstracted using prespecified criteria.
Prescribing of hydroxyurea increased from 13% at baseline to 44%. An additional 53% of patients had a documented reason for no prescription. Decreases in admissions, 30-day readmissions, and lengths of stay resulted in an average savings of 458 bed days per year.
Multidisciplinary care for the adult with SCD provided in the context of the chronic care model can result in significant improvements in important quality targets and may reduce acute resource use.
镰状细胞病（SCD）成人患者的护理往往是零散且昂贵的。慢性护理模式被推荐为为慢性疾病患者提供护理的最佳实践方法。然而，目前尚无发表的报告研究这种方法对 SCD 成人患者的效果。
在一个学术机构为 SCD 成人实施新的多学科计划后，检查特定的质量和利用措施。
获取了 2000-2009 年期间所有因 SCD 而入住成人急诊部门或住院或在成人门诊就诊的成年患者的行政数据。使用预定标准提取了所有在成人多学科镰状细胞诊所就诊的患者的图表。
羟脲的处方从基线时的 13%增加到 44%。另有 53%的患者没有开具处方的记录原因。住院、30 天再入院和住院时间的减少导致每年平均节省 458 个床位日。
在慢性护理模式背景下为 SCD 成人提供的多学科护理可显著改善重要的质量指标，并可能减少急性资源的使用。
Zotero 插件