慢性病管理对患者疾病诊疗及经济负担的影响研究

Study on Influence of Chronic Disease Management on Patients'Disease Treatment and Economic Burden

目的分析慢性病管理对慢性病患者住院天数、经济负担、自我感受负担、照顾者负担及生活质量的影响。方法选取慢阻肺、冠心病、慢阻肺合并冠心病的200例慢性病住院患者为研究对象,2017年1月—12月住院的患者行常规管理,2018年1月—12月的住院患者采用慢性病管理方案进行管理,比较慢性病管理方案实施前后,患者年平均住院次数、住院天数、年医疗费用、自我感受负担、照顾者负担及生活质量。结果186例有效随访病例中,包括慢阻肺81例、冠心病74例,慢阻肺合并冠心病31例;慢性病管理方案实施后,慢阻肺、冠心病或慢阻肺合并冠心病患者年住院次数、住院天数、年医疗费用显著少于实施前(p<0.05),自我感受负担量表(SPBS)、Zarit照顾者负担量表(ZBI)评分均显著低于实施前(p<0.05),世界卫生组织生活质量测定量表简表(WHOQOL-BREF)评分显著高于实施前(p<0.05)。结论实施慢性病管理方案可减少慢阻肺、冠心病或慢阻肺合并冠心病患者年住院天数、减轻经济负担,对提高患者生活质量有积极意义。

Objective To analyze the influence of chronic disease management on length of stay,economic burden,self-perceived burden,caregiver burden and quality of life of patients with chronic diseases.Methods A total of 200 inpatients who were diagnosed with chronic obstructive pulmonary disease(COPD),coronary heart disease(CHD)or COPD complicated with CHD were selected for the study.Routine management was performed for the patients from January 2017 to December 2017,and chronic disease management regimen was adopted for the patients from January 2018 to December 2018.The average annual hospitalization frequency,length of stay,annual medical costs,self-perceived burden,caregiver burden and quality of life were compared before and after the chronic disease management regimen implementation.Results There were 186 valid followup cases,including 81 cases of COPD,74 cases of CHD and 31 cases of COPD complicated with CHD.After the implementation of chronic disease management,the annual hospitalization frequency,length of stay and annual medical costs of patients with COPD,CHD or COPD complicated with CHD significantly decreased(p<0.05).The scores of Self-Perceived Burden Scale(SPBS)and Zarit Burden Interview(ZBI)were significantly lower after the implementation(p<0.05).The World Health Organization Quality of Life Brief Version(WHOQOL-BREF)score was significantly higher after the implementation(p<0.05).Conclusion The implementation of chronic disease management regimen can shorten the length of stay and relieve the economic burden of patients with COPD,CHD or COPD complicated with CHD,which is of positive significance for improving quality of life of patients.