Department of Family Medicine, Wroclaw Medical University, 1 Syrokomli St., 51-141, Wroclaw, Poland.
Opole Medical School, 68 Katowicka Street, 45-060, Opole, Poland.
Adv Exp Med Biol. 2018;1040:47-62. doi: 10.1007/5584_2017_84.
Coordination of healthcare effectively prevents exacerbations and reduces the number of hospitalizations, emergency visits, and the mortality rate in patients with chronic respiratory diseases. The purpose of this study was to determine clinical effectiveness of ambulatory healthcare coordination in chronic respiratory patients and its effect on the level of healthcare services as an indicator of direct medical costs. We conducted a retrospective health record survey, using an online database of 550 patients with chronic respiratory diseases. There were decreases in breathing rate, heart rate, and the number of cigarettes smoked per day, and forced vital capacity (FVC) and forced expired volume in 1 s (FEV1) increased after the implementation of the coordinated healthcare structure. These benefits were accompanied by increases in the number of visits to the pulmonary outpatient clinic (p < 0.001), diagnostic costs (p < 0.001), and referrals to other outpatient clinics (p < 0.003) and hospitals (p < 0.001). The advantageous effects of healthcare coordination on clinical status of respiratory patients above outlined persisted over a 3-year period being reviewed.
医疗保健的协调可有效预防恶化,减少慢性呼吸系统疾病患者的住院次数、急诊次数和死亡率。本研究的目的是确定在慢性呼吸系统疾病患者中进行门诊医疗保健协调的临床效果,以及其作为直接医疗费用指标的医疗服务水平的影响。我们进行了一项回顾性健康记录调查,使用了 550 名慢性呼吸系统疾病患者的在线数据库。实施协调医疗保健结构后,呼吸频率、心率和每天吸烟的数量减少,用力肺活量(FVC)和 1 秒用力呼气量(FEV1)增加。这些好处伴随着肺门诊就诊次数(p < 0.001)、诊断费用(p < 0.001)以及向其他门诊和医院转诊次数(p < 0.003)的增加。在审查的 3 年期间,医疗保健协调对呼吸系统疾病患者临床状况的有利影响持续存在。