个案管理模式在我国慢性病中的应用进展

Inspiration of the application of case management model in chronic diseases in China

个案管理模式是一种新型疾病照护模式，目前在我国慢性病的护理管理实践和应用中存在多种问题，如缺乏系统、具体的运行规范等。本文就个案管理模式在我国慢性病管理的实践进行梳理和总结，阐述了个案管理概念、模式角色设定、模式实践关键环节及其主要评价指标和个案管理在我国慢性病领域的主要实践现况及存在问题，并根据存在问题提出相关可行的建议，为个案管理模式运用到慢病连续性照护模式提供参考及奠定基础。

Case management model is a new kind of disease care model, but there were many problems in the practice and application of nursing management in the management of chronic care in our country, such as lack of system .and specific operation specification, etc. This article reviewed and summarized the practice of case management model in the management of chronic diseases in China, and expounded the concept of case management, the setting of model role, the key link of practice, the main evaluation index and the practice situation and existing problems in the case management chronic diseases, and put forward relevant feasible suggestion according to the existing problems, so as to provide reference and foundation for the construction of continuous care model in chronic diseases.