全科医师社区“ABC”慢性病管理模式效果分析

Analysis of the effect of ABC chronic disease management model in general practitioner community

目的:探讨全科医师在社区中开展"ABC"慢性病管理模式的效果。方法:收治2型糖尿病患者320例,平分为两组。对照组患者仅进行常规疾病控制中心管理方法管理,干预组患者会得到签约全科医师的定期随访,给予生活方式等方面的建议。对比干预前和干预10个月后患者空腹血糖、糖化血红蛋白、体重指数(BMI)及血脂情况。结果:干预后两组患者的血糖、血脂均较干预前有所下降,干预组患者的血糖、血脂下降明显,BMI无明显变化。结论:ABC慢性病管理模式对社区慢性病管理效果显著。

Objective:To explore the effect of"ABC"chronic disease management model in community by general practitioners. Methods:320 patients with type 2 diabetes were selected,they were divided into the two groups on average.Patients in the control group were only managed by the conventional CDC management method,and patients in the intervention group were followed up regularly by the contracted general practitioners and given lifestyle suggestions.The fasting blood glucose,glycosylated hemoglobin, BMI index and blood lipid were compared before and 10 months after intervention.Results:After the intervention,the blood glucose and lipids of the two groups decreased slightly compared with those before the intervention.The blood glucose and lipids of the patients in the intervention group decreased significantly,and the BMI of the two groups did not change significantly.Conclusion: ABC chronic disease management model has significant effect on community chronic disease management.