How to improve care in outpatients with cirrhosis and ascites: A new model of care coordination by consultant hepatologists
How to improve care in outpatients with cirrhosis and ascites: A new model of care coordination by consultant hepatologists
复制标题
DOI：
10.1016/j.jhep.2013.03.010
复制
发表时间：
2013-08-01
影响因子：
25.7
通讯作者：
Angeli, Paolo
中科院分区：
文献类型：
--
作者：
Morando, Filippo;Maresio, Giulio;Angeli, Paolo
背景与目的：肝硬化患者腹水的发生与高医疗利用率有关。为了优化其管理，必须建立新的专门化后勤支助模式。该研究的目的是评估“护理管理检查”作为一种新的专业化医疗支持模式的有效性和财务可持续性，该模式基于真实的时间内进行的一系列诊断设施，以及医院门诊部肝病专家顾问、专职护士、培训医生和主治医生的综合活动，与标准治疗相比，在门诊肝硬化和腹水患者中。方法：将100例住院的糖尿病患者在出院后分为“护理管理检查”组（第1组）和“标准门诊护理”组（第2组），并作为门诊患者前瞻性随访至死亡或至少12个月。当需要进行侵入性手术时，两组患者也可以进入“日间医院”。第1组中，“护理管理检查”和“日间医院”一起定义了“护理管理计划”。结果：第2组的12个月死亡率高于第1组（45.7%比23.1%，p
Background & Aims: The development of ascites in patients with cirrhosis is associated with a high rate of health care utilization. New models of specialized caregiving support are necessary to optimize its management. The aim of the study was to evaluate the efficacy and financial sustainability of the "Care management check-up" as a new model of specialized caregiving support based on a series of diagnostic facilities performed in real time and on the integrated activity of consultant hepatologists at the hospital unit for outpatients, dedicated nurses, physicians in training and primary physicians, compared to standard care in outpatients with cirrhosis and ascites.Methods: 100 cirrhotic patients admitted to our hospital were allocated, after discharge, to the "Care management check-up" group (group 1), or to the "Standard outpatient care" group (group 2), and followed prospectively as outpatients up to death or for at least 12 months. Patients of the two groups could also access to a "Day hospital" when an invasive procedure was required. In group 1, the "Care management check-up" and the "Day hospital" taken together defined the "Care management program".Results: Twelve-month mortality was higher in group 2 than in group 1 (45.7% vs. 23.1%, p