CAJ | 학술논문

目的：探索以全科诊疗为服务主路径的模式对社区公共卫生管理的效果，为其他地区社区公卫管理模式提供参考。方法以社区健康服务中心为主要服务场所，将全科诊断、治疗、筛查、重点人群分类管理、随访追踪等一系列连贯的服务融为一体，集于同一团队完成的模式称为“以全科诊疗为服务主路径模式”，简称为“主路径”。对“主路径”管理模式（2014年1～12月）和“专科管理”模式（2013年1～12月）进行现场研究，从慢性病管理、老年人管理、儿童保健、免疫接种的数量、及各重点人群管理的质量、管理效果等方面进行比较分析。结果以全科诊疗为服务主路径的模式与专科团队的管理模式相比，高血压、糖尿病患者筛查数、月均儿童保健人次数及月均免疫接种数分别增长120.83％、208.00%、128.57%、51.87%，高血压患者与糖尿病患者管理数量分别增长21.72％和140.00％，慢性病患者档案资料完整率及儿童系统管理率均较高，患者满意度差异有统计学意义（P ＜0.05)。结论以全科诊疗为服务主路径的模式对社区公共卫生管理效果良好，值得推广。
목적：탐색이전과진료위복무주로경적모식대사구공공위생관리적효과，위기타지구사구공위관리모식제공삼고。방법이사구건강복무중심위주요복무장소，장전과진단、치료、사사、중점인군분류관리、수방추종등일계렬련관적복무융위일체，집우동일단대완성적모식칭위“이전과진료위복무주로경모식”，간칭위“주로경”。대“주로경”관리모식（2014년1～12월）화“전과관리”모식（2013년1～12월）진행현장연구，종만성병관리、노년인관리、인동보건、면역접충적수량、급각중점인군관리적질량、관리효과등방면진행비교분석。결과이전과진료위복무주로경적모식여전과단대적관리모식상비，고혈압、당뇨병환자사사수、월균인동보건인차수급월균면역접충수분별증장120.83％、208.00%、128.57%、51.87%，고혈압환자여당뇨병환자관리수량분별증장21.72％화140.00％，만성병환자당안자료완정솔급인동계통관리솔균교고，환자만의도차이유통계학의의（P ＜0.05)。결론이전과진료위복무주로경적모식대사구공공위생관리효과량호，치득추엄。
Objective To explore the full service clinics for primary path model for community public health management effectiveness, provide a reference for other areas of community public health management. Methods community health service center as the main service establishments, the integration of general diagnosis, treatment, screening, focus groups classified management, follow-up and a series of coherent tracking service, set in the same team to complete the pattern called "full clinics to serve the main path model ", referred to as the"main path". On the "main path" management model(2014.1-2014.12)and "specialist management" mode(2013.1-2013.12) field studies, comparative analysis from the aspects of chronic disease management, elderly management, child care, immunization of quantity, quality management and various focus groups, management effects. Results Compared with full service clinics for primary path model and specialist management team, high blood pressure, the number of screening for diabetes, the average monthly number of child health and human immune average monthly increase of 120.83%, respectively, the number of vaccination, 208.00%, 128.57 %, 51.87, and the number of patients with hypertension in patients with diabetes management grew 21.72% and 140.00%, respectively, in patients with archive management system complete rate and child rates, patient satisfaction was statistically significance (P < 0.05). Conclusion Full service clinics for primary path model for community public health management works well, worthy of promotion.