浙江省风湿科慢病管理现状调查

Investigation of Chronic Disease Management in Rheumatology and Immunology Department in Zhejiang Province

目的了解浙江省风湿科慢病管理现状,以期为类风湿关节炎慢病管理专家指导建议的制订提供相关依据。方法选取2020年7月12—26日浙江省36家重点医院风湿科,三甲医院27家,三乙医院9家。由统一培训的调查小组对医务人员进行面对面访谈。被调研人中57%为风湿科室主任,25%为副主任,8%为主治医师,其余为科主任指定人员参与调研。结果36家医院全部完成调查,63%风湿科已开展风湿慢病管理,97%风湿科室认同需要进行慢病管理,90%的风湿科室认为需要数字化的慢病管理工具,68%的科室希望数字化慢病管理工具能够覆盖风湿免疫领域的全病种。科室管理者认为数字化慢病管理工具需要满足医护人员随访提醒(100%)、患者材料推送(95%)、患者分类(95%)等工作。同时还需要满足患者服药提醒(92%)、线上问诊(68%)等需求。36家重点医院中,92%的风湿科认为目前慢病管理效果未达到理想状态,仅有4%风湿病患者进入固定慢病管理流程。在关于患者随访工具的调研中,使用最广泛的是个人微信或微信群,占34%;其次是电话随访,占22%;利用“好大夫”“风湿中心”等新兴APP或网站进行随访的科室不到20%。97%的风湿科学科管理者认为解决风湿慢病管理的关键在于构建统一的慢病管理模式。结论浙江省风湿科开展慢病管理需求大,管理现状不理想,区域内管理模式不能互通。该调查以期为类风湿关节炎慢病管理专家指导建议的制订提供相关依据,探索慢病管理新模式,从而改善慢病管理现状。

Objective To understand the current situation of chronic disease management in Zhejiang Province,in order to provide relevant basis for the formulation of expert advice on chronic disease management of rheumatoid arthritis.Methods From July 12-26,2020,the rheumatology departments of 36 key hospitals in Zhejiang Province were selected,including 27 third-class hospitals and 9 third-class hospitals.Face-to-face interviews with medical staff are conducted by uniformly trained investigation teams.Among the respondents,57%were the director of the rheumatology department,25%were the deputy director,8%were the treating physician,and the rest were the personnel designated by the director of the department.Results All 36hospitals completed the survey,63%of rheumatic departments had carried out rheumatic immune chronic disease management,97%of rheumatic departments recognized the need for chronic disease management,90%of rheumatic departments believed that digital chronic disease management tools were needed,and 68%of departments hoped that digital chronic disease management tools could cover all kinds of diseases in the field of rheumatic immunity.Department managers believe that digital chronic disease management tools need to meet the needs of medical staff follow-up reminder(100%),patient material push(95%),patient classification(95%),as well as patient medication reminder(92%)and online consultation(68%)and other needs.Among the 36 key hospitals,92%of rheumatic immunology specialists believe that the current chronic disease management effect has not reached the ideal state.Only 4%of rheumatic immunology patients enter the fixed chronic disease management process.In the research on patient follow-up tools,personal wechat or wechat group is the most widely used,accounting for 34%;followed by telephone follow-up,accounting for 22%;and"good doctor","Rheumatism center"and other emerging APP or websites are followed up by less than 20%of the departments.97%of the department managers of rheumatism immunology think that the key to solve the chronic disease management of rheumatism immunology is to build a regional specialized medical integrated chronic disease management model.Conclusion The department of rheumatology in Zhejiang Province has a great demand for chronic disease management,the management status is not ideal,and the management mode within the region cannot communicate with each other.The investigation is expected to provide relevant basis for the formulation of expert guidance and suggestions on chronic disease management of rheumatoid arthritis,and explore a new mode of chronic disease management,so as to improve the current situation of chronic disease management.