梅奥医学中心合作模式的高血压分级诊疗与实践

Hypertension classification diagnosis of Mayo Clinic cooperation model and its practice

目的探讨梅奥医学中心合作模式高血压分级诊疗的应用价值。方法选择2018年1~10月在深圳市宝安区分级诊疗试点诊治的高血压患者1000例,随机分为观察组和对照组,每组500例。对照组患者进行常规诊疗管理,观察组患者采用梅奥中心合作模式进行分级诊疗管理。比较干预前和干预12个月后两组患者日间血压波动情况、高血压管理率、血压控制率以及干预12个月的治疗总费用和患者对诊疗管理的满意度。结果干预12个月后,共有962例患者获得随访。干预12个月后,两组患者的日间收缩压和舒张压波动幅度均显著减小,差异有统计学意义(P<0.05),但两组患者的日间收缩压和舒张压波动幅度比较差异均无统计学意义(P>0.05);两组患者的高血压管理率和血压控制率均显著提高,观察组患者的水平显著高于对照组,差异有统计学意义(P<0.05)。干预12个月两组患者的治疗总费用比较差异无统计学意义(P>0.05);观察组患者对诊疗管理的满意度显著高于对照组,差异有统计学意义(P<0.05)。结论采用梅奥医学中心合作模式对高血压患者进行分级诊疗有利于提高高血压管理率、血压控制率和患者对诊疗管理的满意度。

Objective To explore the application value of hypertension classification diagnosis of the Mayo Clinic cooperation model.Methods A total of 1000 hypertensive patients diagnosed and treated at experimental unit of hierarchical diagnosis and treatment in Baoan District of Shenzhen from January 2018 to October 2018 were selected,and were randomly divided into observation group and control group,with 500 cases in each group.The patients in the control group were managed by routine diagnosis and treatment,and the Mayo Clinic cooperation model was employed on the observation group to conduct the management of hierarchical diagnosis and treatment.The twelve-month pre-and post-intervention diurnal blood pressure fluctuations,hypertension management rate,blood pressure control rate,the total cost of treatment 12 months after intervention,and the satisfaction of patients on management of diagnosis and treatment were compared between the two groups.Results After 12 months of intervention,a total of 962 patients were followed up.Twelve months after intervention,the fluctuation amplitudes of diurnal systolic and diastolic blood pressure significantly decreased in both groups,with statistically significant differences(P<0.05),but the differences of fluctuation amplitudes in diurnal systolic and diastolic blood pressure between the two groups were not statistically significant(P>0.05);the hypertension management rate and blood pressure control rate significantly increased in both groups,and the abovementioned rates of the observation group were significantly higher than those of the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the total cost of treatment between the two groups 12 months after intervention(P>0.05).The satisfaction on management of diagnosis and treatment was higher in the observation group than in the control group,with statistically significant difference(P<0.05).Conclusion Using the Mayo Clinic cooperation model for hierarchical diagnosis and treatment on patients with hypertension is conducive to increasing the management rate of hypertension,blood pressure control rate and satisfaction on management of diagnosis and treatment in patients.