长三角一体化建设背景下远程医疗服务在社区卫生服务中心的应用研究

来源:用户上传      作者:张丽红 蒋雪美 沈剑 王闻婧

　　摘 要 目的：通^分析上海市青浦区金泽镇社区卫生服务中心接受远程医疗就诊服务患者的相关诊疗信息，了解患者对远程医疗服务的需求情况。方法：以2021年8月18日―2021年11月30日在青浦区金泽镇社区卫生服务中心接受远程医疗就诊的201例患者为研究对象，通过远程医疗协同平台收集所有接受远程医疗服务患者的相关信息。结果：就诊患者人次较多的科室分别为中医内科、心内科、消化内科、骨科和内分泌科。排在前5位的患者就诊原因分别为慢性疼痛（16.8%）、2型糖尿病（10.6%）、失眠（7.1%）、泌尿道感染（5.1%）和慢性肾炎（4.7%）。远程医疗诊疗方案主要分为随诊开药、完善检查、咨询解答、线下转诊和其他，其中随诊开药和完善检查的占比较高。201例患者中，30例患者的远程医疗就诊次数≥2次，占比为14.9%。结论：远程医疗服务仍存在不少问题有待改进：（1）社区卫生服务中心的药物品种较为单一，远程诊疗的处方用药配备不齐全，无法满足患者用药需求，建议建立医疗联合体范围内的“共享药房”；（2）开展远程中医诊疗具有良好的群众基础，应对陪同协助进行远程诊疗的家庭医生进行系统的中医相关知识培训，为远程医疗专家提供详实、可靠的病史资料，更好地满足患者的远程中医服务需求。
　　关键词 远程医疗服务；社区卫生服务中心；老年患者
　　中图分类号：R197.1 文献标志码：A 文章编号：1006-1533（2022）14-0007-04
　　引用本文 张丽红， 蒋雪美， 沈剑， 等. 长三角一体化建设背景下远程医疗服务在社区卫生服务中心的应用研究[J].上海医药， 2022， 43（14）： 7-10.
　　Research of the application of telemedicine services in community health service centers under the background of integrated construction in the Yangtze River Delta
　　ZHANG Lihong1， JIANG Xuemei1， SHEN Jian1， WANG Wenjing2（1. Jinze Community Health Service Center of Qingpu District， Shanghai 201718， China； 2. Traditional Chinese Medicine Department of Jinze Community Health Service Center of Qingpu District， Shanghai 201718， China）
　　ABSTRACT Objective： To understand the patient’s demand for telemedicine services by analyzing the relevant diagnosis and treatment information of patients receiving telemedicine services at Jinze Community Health Service Center in Qingpu District， Shanghai. Methods： A total of 201 patients who received telemedicine visits in Jinze Community Health Service Center of Qingpu District， from August 18， 2021 to November 30， 2021 were selected as the research objects， and relevant information of all patients receiving telemedicine services through telemedicine collaboration platform was collected. Results： The departments with more patients were TCM internal medicine， cardiology， gastroenterology， orthopedics and endocrinology. The top 5 reasons for patients to seek medical treatment were chronic pain（16.8%）， type 2 diabetes（10.6%）， insomnia（7.1%）， urinary tract infection（5.1%） and chronic nephritis（4.7%）. The telemedicine diagnosis and treatment plan was mainly divided into followup prescription， perfect examination， consultation and answer， offline referral and others， among them， the proportion of followup prescription of medicine and perfect examination was relatively high. Among the 201 patients， 30 patients had ≥2 telemedicine visits， accounting for 14.9%. Conclusion： There are still many problems in telemedicine services that need to be improved： （1）The variety of drugs in the community health service center is relatively simple， the prescription drugs for remote diagnosis and treatment are not fully equipped and cannot meet the needs of patients， so it is recommended to establish a “shared pharmacy”within the scope of medical consortiums ； （2） There is a good mass base for telemedicine TCM diagnosis and treatment， and family doctors who accompany and assist in telemedicine diagnosis and treatment should be systematically trained in TCM related knowledge to provide telemedicine experts with detailed and reliable medical history data， and better meet the needs of patients’ remote traditional Chinese medicine service.

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