远程数字化平台对某部干休所骨质疏松症患者的健康管理效果评价

Effect assessment of health management of remote medical digital platform on osteoporosis patients in a cadre's sanitarium

目的评价远程数字化平台对我院附属某部干休所门诊部骨质疏松症患者的一体化健康管理的临床效果。方法选取我院附属某部干休所门诊部骨质疏松症患者为研究组(170例),我院本部门诊骨质疏松症患者为对照组(245例)。所有病例于2013年12月至2015年3月完成入组,研究组进行基于远程数字化平台的骨质疏松症一体化健康管理,对照组不应用远程系统,但仍采用基于数字化平台的骨质疏松症一体化健康管理,随访期限1年。对比分析两组患者骨折发生率、药物依从性、骨质疏松知识、骨密度及研究组转诊率变化。结果研究组和对照组患者1年内骨折发生率均较低(2.94%,3.26%),钙剂、维生素D、双膦酸盐药物依从性良好的人数比例均较高(82.35%,83.26%;77.06%,75.10%;70.00%,72.65%),两者比较均没有统计学差异(P>0.05)。随访1年时,研究组骨质疏松知识OKT分值(20.94±2.38)与对照组(21.26±2.91)均比入组时(13.52±2.68,13.82±2.73)增高(P=0.000),但两者相比没有统计学差异(P>0.05);研究组腰椎(L1-L4)及股骨颈骨密度(0.7882±0.0946 g/cm2,0.6741±0.0814 g/cm2)与对照组(0.7946±0.1037 g/cm2,0.6872±0.0907 g/cm2)均比入组时增高(P=0.000),但两者相比没有统计学差异(P>0.05)。研究组患者转诊率(18.14%)与前1年(73.28%)相比有显著降低(P=0.000)。结论远程数字化平台对我院附属某部干休所门诊部骨质疏松症患者的一体化健康管理效果与我院本部相似,且可使转诊率显著降低,有利于部队实现分级诊治,值得推广。

Objective To evaluate the clinical effect of integrated health management of remote medical digital platform on osteoporosis patients in a cadre＇s sanitarium outpatient which is affiliated to our hospital. Methods The patients in a affiliated outpatient of our hospital were selected as research group（n = 170）,while those in our hospital outpatient were selected as control group（n = 245）. All patients were enrolled from December 2013 to March 2015. The research group patients were intervened by integrated health management of remote medical digital platform for osteoporosis,while control group without telemedicine. The follow-up period lasted 1 year. The fracture rate,drug compliance,osteoporosis knowledge（OKT）,bone mineral density（BMD）and referral rate were analyzed. Results The fracture rates of both research group（2. 94%） and control group（3. 26%） were low. The number of patients who had good medicine adherence of calcium,vitamin D and bisphosphonate in both research group（82. 35%, 77. 06%, 70. 00%） and control group（883. 26%, 75. 10%, 72. 65%） were all high. The differences between the groups was not significant（P〈0. 05）. At 1 year of follow-up,the OKT score of research group（20. 94 ± 2. 38） and control group（21. 26± 2. 91） were higher than those at baseline（13. 52 ± 2. 68,13. 82 ± 2. 73）（P = 0. 000）,but there were no significant differences between the two groups（P〈0. 05）. The BMD of lumbar spine（L1-L4） and femoral neck of research group（0. 7882 ± 0. 0946 g/cm2,0. 6741 ± 0. 0814 g/cm2） and control group（0. 7946 ± 0. 1037 g/cm2,0. 6872 ± 0. 0907 g/cm2） were higher than those atbaseline（P = 0. 000）,but there were no significant differences between the two groups（P〈0. 05）. The referral rate in research group（18. 14%） was significantly lower compared with the previous 1 years（73. 28%）（P = 0. 000）. Conclusion The clinical effect of integrated health management of remote medical digital platform on osteoporosis patients in the cadre＇s sanitarium outpatient was similar to our hospital. It could make the referral rate significantly decreased and be conducive to classification of diagnosis and treatment in army,which was worthy of promotion.