基于电子健康档案的糖尿病管理研究

Studies on Diabetes Management Based on the Electronic Health Records System

目的:研究基于电子健康档案系统的糖尿病管理的有效性及经济性。方法:利用社区卫生服务信息化系统建立患者电子健康档案(EHR)及糖尿病专档进行管理,管理期1年,评价管理前后患者的行为、自我管理能力和药费的变化以及血糖、HbAlc、血压、血脂控制的情况。结果:规范管理率达96.8%。管理前后各项指标均有显著改善,平均FPG下降4.4mmol/L,2hPG下降6.4mmol/L,HbA1c下降2.3%,血压、血脂达标率明显上升,平均医疗费用支出下降146.3元/月,患者的认知能力及自我管理能力有了明显提高。结论:糖尿病是一种终身性疾病,其控制不是传统意义的治疗,而是系统的管理。基于电子健康档案的糖尿病管理能有效减轻社区医护人员工作负担,提高规范管理率,提高管理效果,实现患者长期、稳定的病情控制,减少患者医疗费用的支出,提高患者的认知行为及自为管理能力,值得进一步研究和推广。

Objective： To study the effectiveness and economy of the diabetes management based on the electronic health records system. Methods： Establish the electronic patient health records（EHR） and diabetes documents by using the community health service information system with the aim of managing the diabetes patients. To evaluate the behavior of the patients before and after the management, including self-management ability, medicine changes, and blood glucose, HbAlc, blood pressure, blood lipid control. During the management, the standard rate arrived at 96.8% and got a good evaluation on the changes of the patient＇ s behavior, self-manage ability, drug costs, glucose, HbAlc, blood pressure, and blood lipid controlling. Results： Many indicators had improved that after the management, the average FPG, 2 h PG and HbAlc decreased to 4.4 mmol/L, 6.4 mmol/L, and 2.3%, respectively. Meanwhile, the ratios up to the standard of blood pressure and lipid compliance had raised significantly. Besides, the average medical costs had declined and the patients＇ cognitive ability and self-management ability had improved significantly. Conclusion： AS the diabetes is a lifelong disease, the control of it does not refer to the traditional treatment, but the systematically management. The management for the diabetes patients basing on electronic patient health records can reduce the work burden on the health care workers of the community effectively, increasing the rates of standard management, improving management effectiveness, to achieve the long- term and stable disease control in patients and reduce the medical expenses of patients as well as improve patients＇ cognitive behavior and self-management capabilities. To sum up, it is worth to research further and deeply on the management method.