区域医疗中心与基层医疗卫生机构联合管理模式对急性脑梗死患者诊治时间的影响

摘要

目的 研究区域医疗中心与基层医疗卫生机构联合管理模式是否能明显缩短农村及乡镇地区急性脑梗死患者的诊治时间.方法 区域医疗中心与基层医疗卫生机构设立专门管理小组,建立联合管理模式,小组中的专门人员针对农村及乡镇地区急性脑梗死患者(观察组,n=200)的就诊、转诊、检查及治疗等全部诊治过程进行管理和指导,记录转诊时间、候诊时间、从发病到神经内科专科就诊时间、检查时间、就医时间,并与同期未进行联合管理的急性脑梗死患者(对照组,n=200)所用时间进行比较.结果 联合管理的观察组患者转诊时间[(0.47±0.11)小时]、候诊时间[(2.69±0.87)分钟]、就诊时间[(17.07±1.41)小时]、就医时间[(17.31±1.41)小时]和检查时间[(17.01±4.24)分钟]明显低于对照组[分别为(28.12±3.17)小时、(15.37±0.62)分钟、(41.99±3.43)小时、(53.14±3.78)小时和(90.60±4.80)分钟],差异均有显著性(P＜0.05).结论 区域医疗中心与基层医疗卫生机构联合管理模式能明显减少农村及乡镇地区脑梗死患者的院前及院内延误时间,是适用于农村及乡镇地区患者可行的急性脑梗死临床管理模式.%Objective To study whether the regional medical center and basic medical institutions combined management model can obviously shorten diagnosis and treatment time of acute cerebral infarction patients in the rural and township areas. Method Regional medical center and basic medical institutions set up a special management team and personnel management mode. Specialized personnel of management team managed and guided acute cerebral infarction patients (n=200) in rural and township areas all diagnosis and treatment process of seeing a doctor, referral, examination and treatment process. The time of referral, waiting to see a doctor,from the onset to the neurology department clinic, inspection and from the onset to arrival at the neurology department to accept the treatment was recorded. The time was compared with no personnel management patients with acute cerebral infarction (n=200) during the same period. Result The time of referral[(0.47±0.11)h], waiting to see a doctor[(2.69±0.87)min], from the onset to the neurology department clinic[(17.07±1.41)h] and from the onset to arrival at the neurology department to accept the treatment [(17.31±1.41)h]in personnel management patients with acute cerebral infarction was significantly lower than the time in no personnel management patients[(28.12±3.17)h, (15.37±0.62)min, (41.99±3.43)h, (53.14±3.78)h)]. The inspection time[(17.01±4.24)min] in personnel management patients with acute cerebral infarction was significantly lower than the time in no personnel management patients[(90.60±4.80)min]. There was significant difference between the two groups of all (P＜0.05). Conclusion The regional medical center and basic medical institutions combined management model could obviously shorten pre-hospital and hospital delaying time of acute cerebral infarction patients in the rural and township areas. The clinical management model of acute cerebral infarction is suitable and feasible for the patients in the rural and township areas.