城市社区2型糖尿病诊治临床路径的设计及双向转诊机制的建立

Development of clinical pathways and two-way referral system for type 2 diabetes in an urban community

目的 开发设计适合我国城市社区人群2型糖尿病诊治的临床路径。方法 采用文献法、专家会议法、现场考察和预试验的方法,研制中国城市社区人群的2型糖尿病诊治的临床路径。结果 建立了2型糖尿病的社区照顾路径、酮症酸中毒专科诊疗路径、低血糖症患者专科诊疗路径、2型糖尿病患者社区专科双向转诊技术路径和管理路径、单纯2型糖尿病患者专科诊疗路径。结论2型糖尿病诊治的临床路径是以循证医学为指导,在强调诊疗服务标准化的同时,突出了全科医学连续性照顾的特点。

Objective The purpose of this study was to develop clinical pathways and two-way referral system for management of the patients with type 2 diabetes in an urban community.MethodsClinical pathways and two-way referral for management of the patients with type 2 diabetes in urban communities were developed by literature retrieval and review,expert discussion,field ovservation and preliminary test and implenented,on a trial basis,in an urban community.Results The clinical pathways for management of the patients with type 2 diabetes in urban communities were develope,including those in community,in hospital for ketoacidosis,hypoglycemia and uncomplicated diabetes,and two-way referral technical and management pathways between community health care service centers and hospitals.Conclusions The clinical pathways for the patients with type 2 diabetes is evidence-based,which not only emphasize the standardization of health care service,but also stand out the characteristics of continuity of health care in general practice