个案管理在糖尿病患者管理中的应用现状及展望

Application&outlook of case management model in the management of diabetic patients

糖尿病具有治疗时间长、医疗费用高、身心负性症状多且明显等特点,易导致患者及其照护者的生存质量严重下降。因此,建立以患者及其家庭为中心的个性化管理模式是发展糖尿病照护的必由之路。通过查阅大量文献发现,发达国家及我国台湾地区糖尿病个案管理成效显著,相较之下,我国大陆尚未建立相关个案管理制度,个案管理师缺乏,成效评价指标不完善。在今后的研究与实践中,应当深入讨论如何构建适合我国国情的糖尿病个案管理模式,如何培养个案管理师,如何实现个案管理跨专业、跨机构工作并充分整合优势资源等问题。

Diabetes has the characteristics of long treatment time,high medical cost,many and obvious physical and mental negative symptoms,which may lead to serious decline in the quality of life of patients and their caregivers.Therefore,it is the only way to develop diabetes care to establish a personalized management model centering on patients and their families.By referring to a large number of literatures,it is found that the management of diabetes cases in developed countries and Taiwan has achieved remarkable results.In contrast,China has not established a relevant case management system in China's Mainland.In the future research and practice,it is necessary to discuss how to build a case management model of diabetes that is suitable for China s national conditions,how to train case managers,how to realize cross-specialty and inter-agency work of case management,and how to fully integrate superior resources.