基于医联体的互联网+联动模式的构建与应用效果

Construction and application effect of Internet + linkage model based on medical alliance

目的构建基于医联体的互联网+联动模式并评价其实施效果。方法采用便利抽样法,选取2020年10月—2021年6月上海交通大学医学院附属新华医院崇明分院收治的132例恶性肿瘤行经外周静脉置入中心静脉导管(PICC)化疗且带管出院患者为研究对象,将治疗间歇期返回上海交通大学医学院附属新华医院崇明分院PICC门诊进行PICC维护的67例患者设为对照组,采用常规维护方法。将治疗间歇期选择居住地附近维护点进行PICC维护的65例患者设为观察组,在对照组基础上,采用基于医联体的互联网+联动模式维护方法。比较两组患者PICC自我管理能力、带管满意度、PICC并发症发生率、PICC维护所花的平均费用和平均时间。结果两组患者带管日常生活、带管运动、导管异常情况处理、导管维护依从性及导管管理信心维度得分比较,差异均无统计学意义(P>0.05);两组患者带管满意度调查表得分比较,差异无统计学意义(P>0.05);两组患者PICC并发症发生率比较,差异无统计学意义(P>0.05);观察组患者PICC维护所花的挂号费、维护费、交通费均低于对照组,往返时间、就诊时间均短于对照组,差异均有统计学意义(P<0.05)。结论基于医联体的互联网+联动模式能够保证恶性肿瘤行PICC化疗且带管出院患者的PICC维护质量,提高其PICC自我管理能力,具有良好的经济效益和时间效益。

Objective To construct an Internet+linkage model based on medical alliance and evaluate its implementation effect.Methods From October 2020 to June 2021,convenience sampling was used to select 132 patients with malignant tumors who were treated with peripherally inserted central catheters(PICC)chemotherapy and discharged with catheters in Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine.The 67 patients who returned to the PICC outpatient clinic of Chongming Branch,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine during the treatment interval for PICC maintenance were set as the control group,and the routine maintenance method was adopted.A total of 65 patients who chose maintenance points near their residence for PICC maintenance during the treatment interval were set as the observation group.On the basis of the control group,the maintenance method based on the Internet+linkage mode of medical alliance was adopted.The PICC self-management ability,catheter-carrying satisfaction,PICC complication,average cost and average time spent on PICC maintenance during treatment were compared between the two groups.Results There were no significant differences in the scores of daily life with catheters,exercise with catheters,catheter abnormality handling,compliance with catheter maintenance and confidence in catheter management between the two groups(P>0.05).There was no significant difference in the scores of Catheter Satisfaction Survey in the two groups of patients(P>0.05).There was also no significant difference in the incidence of PICC complications between the two groups(P>0.05).The registration fee,maintenance fee,and transportation fee for PICC maintenance in the observation group were lower than those in the control group,and the round-trip time and visit time were shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusions The Internet+linkage model based on the medical alliance can ensure the quality of PICC maintenance for patients with malignant tumors undergoing PICC chemotherapy and discharged with catheters,and improve their PICC self-management ability,which has good economic and time benefits.