West China School of Nursing/Outpatient Department, West China Hospital, Sichuan University, Chengdu, 610041, China.
Business School of Sichuan University, Chengdu, 610065, China.
Sci Rep. 2022 Apr 5;12(1):5693. doi: 10.1038/s41598-022-09784-8.
At present, more patients suffer from multiple chronic diseases. However, the hospital's existing chronic disease management is carried out according to the department. This means that a patient needs to go to more than one department for a chronic disease treatment. Therefore, this study proposes 6 dimensions (organizational management, medical service support, medical service, community alliance, self-management support, management information system) and 36 questions, to help evaluate the current chronic disease management system in China's large third-class hospitals. In this study, 143 survey samples from doctors and nurses were collected. A principal component analysis was used to extract three key elements of chronic disease management service delivery system (service management organization, management information system, medical core service). Then, multiple regression was used to establish the relationship model between the overall performance of the system and the main elements. Three key service nodes of the system (medical specialist support, patient tracking management and personalized intervention) were determined according to the weight of the regression model. The regression coefficients of the above three main elements show a similar impact on the overall performance of the system, but the key service nodes under each major element have relative differences, including medical specialist support, patient tracking management and personalized intervention. Finally, to establish a chronic disease management system with multiple departmental continuous care for chronic diseases, it is necessary to improve the chronic disease management system from three aspects of medical specialty support, patient tracking management and personalized intervention. This paper proposes corresponding improvement strategies.
目前,有更多的患者患有多种慢性病。然而,医院现有的慢性病管理是按科室进行的,这意味着患者需要去多个科室进行慢性病治疗。因此,本研究提出了 6 个维度(组织管理、医疗服务支持、医疗服务、社区联盟、自我管理支持、管理信息系统)和 36 个问题,以帮助评估中国大型三级医院现有的慢性病管理系统。本研究共收集了来自医生和护士的 143 份调查样本。采用主成分分析提取慢性病管理服务提供系统的三个关键要素(服务管理组织、管理信息系统、医疗核心服务)。然后,采用多元回归建立系统整体绩效与主要要素之间的关系模型。根据回归模型的权重,确定系统的三个关键服务节点(医学专家支持、患者跟踪管理和个性化干预)。上述三个主要要素的回归系数对系统的整体绩效有相似的影响,但每个主要要素下的关键服务节点存在相对差异,包括医学专家支持、患者跟踪管理和个性化干预。最后,为建立多科室连续护理的慢性病管理系统,需要从医学专科支持、患者跟踪管理和个性化干预三个方面改进慢性病管理系统。本文提出了相应的改进策略。