Research on the integrated medical and preventive chronic disease management service model of"one entity with two wings"in primary medical and health institutions
SUN Jian
KOU Zhaoqiang
WANG Enjun
WU Zhenyun
WANG Haibin
YUAN Shusuo
WANG Yuqi
CONG Lin
GONG Chao
Abstract：Based on the perspective of the integration of medical and prevention,Junliangcheng hospital of Dongli District,Tianjin City constructs the integrated medical and preventive chronic disease management service model of"one entity with two wings",aiming to enhance the efficiency and quality of chronic disease management in primary medical and health institutions.Relying on the large chronic disease management team,the the 3+1+N basic management team and the special disease group,this model effectively promotes the deep integration of medical and public health services.Based on the case study of diabetes,it will significantly increase the management rate,control rate and self-management ability of patients with chronic diseases,reduce the incidence of complications,alleviate the medical burden of patients,make reasonable use of medical insurance funds,and at the same time improve the satisfaction of patients and medical staff,thereby improving the health status and quality of life of patients.However,issues such as inadequate informatization,insufficient space and staffing,and lack of incentive policies still exist in this model.It is suggested to accelerate the construction of informatization platforms,scientifically expand space,optimize management processes,and strengthen financial support.
Keywords：integration of medical and preventionchronic disease managementprimary medical and health institutions
Publication Date：2024-10-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 630-635 )