产后访视双向转诊临床路径的试用效果评价研究(1)
【摘要】 目的：探讨产后访视双向转诊临床路径的有效性、可行性。方法：在常平医院及常平社区应用该路径，选取296例产妇及新生儿，随机数字表法分为观察组和对照组，每组各148例产妇及新生儿。观察组按照双向转诊临床路径规定的程序进行诊疗与随访，对照组按照常规方式进行诊疗与随访。结果：医师对双向转诊临床路径的知晓率高达90%以上，孕产妇的知晓率不足60%；两组的转诊率、产后访视率、发病率、患者满意度、人均医疗费用及人均就诊时间比较，差异均有统计学意义(P<0.05)。结论：双向转诊临床路径能规范产后访视双向转诊的流程及转诊的指征，也为产后访视规范化的发展提供依据，还可以优化卫生资源，构建合理就医模式，值得在临床推广应用。
【关键词】 产后访视； 双向转诊； 临床路径
Evaluation Study on Trial Effect of the Postpartum Visit Dual Referral Clinical Pathway/LIU Xiao-qiong，YE Yan-ming，YI Quan-ying，et al.//Medical Innovation of China，2015，12(16)：036-039
, http://www.100md.com
【Abstract】 Objective：To study the effectiveness and feasibility of the postpartum visit dual referral clinical pathway.Method：The postpartum visit dual referral clinical pathway was applied in Changping Hospital and community health service center of Changping town，296 cases of puerperae and newborns were selected，and randomly divided into control group and observation group，148 cases in each group.The observation group was made diagnoses and treatment according to postpartum visit dual referral clinical pathway，the control group was given conventional diagnoses for treatment and follow-up visits.Result：The awareness rate of postpartum visit dual referral clinical pathway in doctors was more than 90%，while in pregnant women and puerperae the rate was less than 60%.Compared the referral rate，postpartum visit rate，morbidity，patients’ satisfaction degree，medical expense per capita and clinic time per capita of two groups，the differences were statistically significant(P<0.05).Conclusion：The postpartum visit dual referral clinical pathway is helpful to standardize the process of postpartum visit dual referral and referral indications，and also provide the basis for the standardizing development of postpartum visit.What’s more，it is beneficial to optimize health resources and build reasonable medical model.So it is worth of widespread clinical application.
, http://www.100md.com
【Key words】 Postpartum visit； Dual referral； Clinical pathway
First-author’s address：Changping Hospital of Dongguan，Dongguan 523770，China
doi：10.3969/j.issn.1674-4985.2015.16.013
目前，产后访视传统工作模式是以医院为中心的妇幼保健体系，即由分娩医院负责产后访视工作[1]。产后康复治疗主要局限在住院期间进行，出院后缺乏有效、连续的产后康复治疗和指导，医院与家庭存在脱节现象，难以满足家庭对母婴保健的全方位、多层次的要求。本课题组于2014年3-6月通过分析国内外关于产后访视双向转诊临床路径的研究现状和发展趋势，组织东莞市的有关专家运用德尔菲(Delphi)法，制定了一套产后访视双向转诊的临床路径，内容主要包括产后访视双向转诊的技术路径、产后访视双向转诊的管理路径及产后访视双向转诊参考指南。搭建了医院与家庭的桥梁，让医院、社区、家庭三者有机结合，使整个围生期保健做到无缝链接，以促进母婴健康。本研究是对产后访视双向转诊临床路径进行试用，观察其效果、效益，评价该路径的可操作性和可推广性，为进一步修改和完善产后访视双向转诊临床路径奠定基础。, http://www.100md.com(刘小琼 叶延铭 易泉英 等)
【关键词】 产后访视； 双向转诊； 临床路径
Evaluation Study on Trial Effect of the Postpartum Visit Dual Referral Clinical Pathway/LIU Xiao-qiong，YE Yan-ming，YI Quan-ying，et al.//Medical Innovation of China，2015，12(16)：036-039
, http://www.100md.com
【Abstract】 Objective：To study the effectiveness and feasibility of the postpartum visit dual referral clinical pathway.Method：The postpartum visit dual referral clinical pathway was applied in Changping Hospital and community health service center of Changping town，296 cases of puerperae and newborns were selected，and randomly divided into control group and observation group，148 cases in each group.The observation group was made diagnoses and treatment according to postpartum visit dual referral clinical pathway，the control group was given conventional diagnoses for treatment and follow-up visits.Result：The awareness rate of postpartum visit dual referral clinical pathway in doctors was more than 90%，while in pregnant women and puerperae the rate was less than 60%.Compared the referral rate，postpartum visit rate，morbidity，patients’ satisfaction degree，medical expense per capita and clinic time per capita of two groups，the differences were statistically significant(P<0.05).Conclusion：The postpartum visit dual referral clinical pathway is helpful to standardize the process of postpartum visit dual referral and referral indications，and also provide the basis for the standardizing development of postpartum visit.What’s more，it is beneficial to optimize health resources and build reasonable medical model.So it is worth of widespread clinical application.
, http://www.100md.com
【Key words】 Postpartum visit； Dual referral； Clinical pathway
First-author’s address：Changping Hospital of Dongguan，Dongguan 523770，China
doi：10.3969/j.issn.1674-4985.2015.16.013
目前，产后访视传统工作模式是以医院为中心的妇幼保健体系，即由分娩医院负责产后访视工作[1]。产后康复治疗主要局限在住院期间进行，出院后缺乏有效、连续的产后康复治疗和指导，医院与家庭存在脱节现象，难以满足家庭对母婴保健的全方位、多层次的要求。本课题组于2014年3-6月通过分析国内外关于产后访视双向转诊临床路径的研究现状和发展趋势，组织东莞市的有关专家运用德尔菲(Delphi)法，制定了一套产后访视双向转诊的临床路径，内容主要包括产后访视双向转诊的技术路径、产后访视双向转诊的管理路径及产后访视双向转诊参考指南。搭建了医院与家庭的桥梁，让医院、社区、家庭三者有机结合，使整个围生期保健做到无缝链接，以促进母婴健康。本研究是对产后访视双向转诊临床路径进行试用，观察其效果、效益，评价该路径的可操作性和可推广性，为进一步修改和完善产后访视双向转诊临床路径奠定基础。, http://www.100md.com(刘小琼 叶延铭 易泉英 等)