三级医院联合社区医院治疗腰椎间盘突出症模式探索①.pdfVIP

中国康复理论与实践2012年12月第18卷第12期ChinJRehabilTheoryPract,Dec.2012,Vol. 18,No. 12 - 1187 - DOI: 10.3969/j.issn. 1006-9771.2012.12.028 ·康复管理· 三级医院联合社区医院治疗腰椎间盘突出症模式探索① 1 2 3 1 徐义明 ，杨新文 ，方伟明 ，白跃宏 [摘要] 目的 探索社区医院对老年骨关节疾病尤其是腰椎间盘突出症的经济、有效的诊疗模式。方法 将上海市徐家汇社区 卫生服务中心接诊的老年腰椎间盘突出症患者设为观察组(n=62) ，将上海市华泾社区卫生服务中心和上海市第六人民医院接诊的 腰椎间盘突出症患者设为对照组A(n=48)和对照组B(n=55) 。观察组患者由与之联合的三级医院康复科副主任以上医师按照轻、 中、重分级治疗，对照组A 和对照组B 按照常规治疗。3 个月后，对三组患者进行疗效评定和支付费统计。结果 观察组与对照组 B 疗效无显著性差异(P0.05) ，均优于对照组A(P0.05) 。观察组支付费最低(观察组对照组A对照组B) 。结论 社区医院在三级 医院指导下分级治疗老年腰椎间盘突出症既经济又有效。 [关键词] 腰椎间盘突出症；社区康复；模式；老年；治疗费 Management Strategy of Lumbar Disc Herniation in Community Health Center United Tertiary Hospital XU Yi-ming, YANG Xin-wen, FANG Wei-ming, et al. Department of Rehabilitation Medicine, 6th Peoples Hospital, Shanghai Jiaotong University, Shanghai 200233, China Abstract: Objective To explore an economic and effective management strategy for lumbar disc herniation (LDH) in community health center. Methods 62 LDH patients treated in Xujiahui community health center (observation group), 48 LDH patients treated in Hua- jing community health center (control group A) and 55 LDH patients treated in Shanghai 6th Peoples Hospital (control group B) were in- cluded. The observation group was managed by associate professor from Shanghai 6th Peoples Hospital and accepted different treatment strategy in mild, medium and heavy grades. The control groups A and B were managed routinely. 3 month later, costs of illness were comput- ed and curative effects were accessed in 3 groups. Results There was no difference in curative effects between observation group and