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    • 長三角一體化建設背景下遠程醫療服務在社區衛生服務中心的應用研究


    來源:用戶上傳      作者:張麗紅 蔣雪美 沈劍 王聞婧

      摘 要 目的:通^分析上海市青浦區金澤鎮社區衛生服務中心接受遠程醫療就診服務患者的相關診療信息,了解患者對遠程醫療服務的需求情況。方法:以2021年8月18日―2021年11月30日在青浦區金澤鎮社區衛生服務中心接受遠程醫療就診的201例患者為研究對象,通過遠程醫療協同平臺收集所有接受遠程醫療服務患者的相關信息。結果:就診患者人次較多的科室分別為中醫內科、心內科、消化內科、骨科和內分泌科。排在前5位的患者就診原因分別為慢性疼痛(16.8%)、2型糖尿病(10.6%)、失眠(7.1%)、泌尿道感染(5.1%)和慢性腎炎(4.7%)。遠程醫療診療方案主要分為隨診開藥、完善檢查、咨詢解答、線下轉診和其他,其中隨診開藥和完善檢查的占比較高。201例患者中,30例患者的遠程醫療就診次數≥2次,占比為14.9%。結論:遠程醫療服務仍存在不少問題有待改進:(1)社區衛生服務中心的藥物品種較為單一,遠程診療的處方用藥配備不齊全,無法滿足患者用藥需求,建議建立醫療聯合體范圍內的“共享藥房”;(2)開展遠程中醫診療具有良好的群眾基礎,應對陪同協助進行遠程診療的家庭醫生進行系統的中醫相關知識培訓,為遠程醫療專家提供詳實、可靠的病史資料,更好地滿足患者的遠程中醫服務需求。
      關鍵詞 遠程醫療服務;社區衛生服務中心;老年患者
      中圖分類號:R197.1 文獻標志碼:A 文章編號:1006-1533(2022)14-0007-04
      引用本文 張麗紅, 蔣雪美, 沈劍, 等. 長三角一體化建設背景下遠程醫療服務在社區衛生服務中心的應用研究[J].上海醫藥, 2022, 43(14): 7-10.
      Research of the application of telemedicine services in community health service centers under the background of integrated construction in the Yangtze River Delta
      ZHANG Lihong1, JIANG Xuemei1, SHEN Jian1, WANG Wenjing2(1. Jinze Community Health Service Center of Qingpu District, Shanghai 201718, China; 2. Traditional Chinese Medicine Department of Jinze Community Health Service Center of Qingpu District, Shanghai 201718, China)
      ABSTRACT Objective: To understand the patient’s demand for telemedicine services by analyzing the relevant diagnosis and treatment information of patients receiving telemedicine services at Jinze Community Health Service Center in Qingpu District, Shanghai. Methods: A total of 201 patients who received telemedicine visits in Jinze Community Health Service Center of Qingpu District, from August 18, 2021 to November 30, 2021 were selected as the research objects, and relevant information of all patients receiving telemedicine services through telemedicine collaboration platform was collected. Results: The departments with more patients were TCM internal medicine, cardiology, gastroenterology, orthopedics and endocrinology. The top 5 reasons for patients to seek medical treatment were chronic pain(16.8%), type 2 diabetes(10.6%), insomnia(7.1%), urinary tract infection(5.1%) and chronic nephritis(4.7%). The telemedicine diagnosis and treatment plan was mainly divided into followup prescription, perfect examination, consultation and answer, offline referral and others, among them, the proportion of followup prescription of medicine and perfect examination was relatively high. Among the 201 patients, 30 patients had ≥2 telemedicine visits, accounting for 14.9%. Conclusion: There are still many problems in telemedicine services that need to be improved: (1)The variety of drugs in the community health service center is relatively simple, the prescription drugs for remote diagnosis and treatment are not fully equipped and cannot meet the needs of patients, so it is recommended to establish a “shared pharmacy”within the scope of medical consortiums ; (2) There is a good mass base for telemedicine TCM diagnosis and treatment, and family doctors who accompany and assist in telemedicine diagnosis and treatment should be systematically trained in TCM related knowledge to provide telemedicine experts with detailed and reliable medical history data, and better meet the needs of patients’ remote traditional Chinese medicine service.