A Study of the Effective Model of Combination Management of Tertiary Hospitals and Community Hospitals for Home Peritoneal Dialysis Patients_West China Medical Journal

Authors：

 CHENZe-jun ,  GONGRong , PIJing-jing , QUANDa-yong , LIYing-chun , ZHANGDao-ying

Department of Nephrology, the Third Peoples'Hospital of Chengdu/the Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan 610031, P. R. China;

Corresponding?author：

GONGRong, Email: gongr2006@sina.com

Keywords：

Peritoneal dialysis; Tertiary hospital; Community; End-stage renal disease

DOI：

10.7507/1002-0179.20140254

Video：

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Objective To explore the practice effect of the combination management of tertiary hospital and community hospital for home peritoneal dialysis patients. Methods A total of 50 patients of end-stage renal disease from December 2012 to May 2013 were involved in this study, including 26 males, and 24 females with the average age of 47.1±13.9. The patients were randomly divided into hospital group (30 patients) and combination group (20 patients). For the patients in the hospital group, the specialists take care of them with regular outpatient service and follow-up; for the patients in the combination group, they were taken care by doctors from both tertiary hospital and community hospital, while the community general practitioners were trained by the tertiary hospital regularly with peritoneal dialysis basic treatment and standardization management and communication. All the patients were managed for 9 months. Results At the end of the observation,the dialysis adequacy success rate, hemoglobin, blood potassium, phosphorus, calcium, albumin, CO2CP, blood pressure success rate, the incidence of peritonitis, and average monthly medical treatment expense between the two groups were not statistically different (P>0.05); the difference in cost of transportation was statistically significant (P<0.05). Conclusion The standardization manage of combination of tertiary hospital and community for patients with home peritoneal dialysis may reduces the patients' expense in transportation, and improve the community general practitioners' level of basic knowledge and indication of peritoneal dialysis.

Citation： CHENZe-jun, GONGRong, PIJing-jing, QUANDa-yong, LIYing-chun, ZHANGDao-ying. A Study of the Effective Model of Combination Management of Tertiary Hospitals and Community Hospitals for Home Peritoneal Dialysis Patients. West China Medical Journal, 2014, 29(5): 831-834. doi: 10.7507/1002-0179.20140254 Copy

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12.	么麗春, 劉俊青, 王路紅, 等. 居家腹膜透析患者的社區管理探討[J]. 中國全科醫學, 2010, 13(22):2531-2532.
13.	肖月, 宋文舸, 趙琨. 新型農村合作醫療對透析服務管理現狀研究[J]. 衛生經濟研究, 2013(8):17-20.
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15.	吳峰芬, 季曉英, 邱曉園, 等. 不同透析方式對山區透析患者生活質量的影響及相關因素分析[J]. 浙江醫學, 2013, 35(19):1746-1747, 1751.

1. Tesar V. The past, the present and the future of renal replacement therapy[J]. Vnitr Lek, 2011, 57(7-8):603-606.
2. 陳再彬. 國際與我國血液透析發展概況[J]. 健康向導, 2009, 15(3):12.
3. 薄天慧, 高秀, 趙偉, 等. 持續性非臥床腹膜透析患者低鉀血癥發生率與臨床意義[J]. 華西醫學, 2013, 28(6):844-846.
4. Puttinger H. Peritoneal dialysis-an ideal initial dialysis mode[J]. Wien Med Wochenschr, 2013, 163(11/12):271-279.
5. 葛均波, 徐永健. 內科學[M]. 北京:人民衛生出版社, 2013:524-525.
6. 陳香美. 腹膜透析標準操作規程[M]. 北京:人民軍醫出版社, 2010:128-153.
7. Lo WK, Bargman JM, Burkart J, et al. Guideline on targets for solute and fluid removal in adult patients on chronic peritoneal dialysis[J]. Perit Dial Int, 2006, 26(5):520-522.
8. 劉旭, 張東亮, 王剛, 等. 利用三級醫療體系推廣腹膜透析社區化管理模式的初步研究[J]. 中國全科醫學, 2012, 15(34):3972-3974.
9. 田疆, 季煦. 加拿大全科醫生制度建設對中國的啟示[J]. 中國全科醫學, 2013, 16(26):3031-3033.
10. Nicolucci A, Rossi MC, Arcangeli A, et al. Four-year impact of a continuous quality improvement effort implemented by a network of diabetes outpatient clinics:the AMD-Annals initiative[J]. Diabet Med, 2010, 27(9):1041-1048.
11. 劉運杰, 王艷紅, 張智勇, 等. 三級醫院與社區醫院住院患者雙向轉診路徑初探[J]. 中國全科醫學, 2010, 13(7):701-703.
12. 么麗春, 劉俊青, 王路紅, 等. 居家腹膜透析患者的社區管理探討[J]. 中國全科醫學, 2010, 13(22):2531-2532.
13. 肖月, 宋文舸, 趙琨. 新型農村合作醫療對透析服務管理現狀研究[J]. 衛生經濟研究, 2013(8):17-20.
14. Germain MJ, Cohen LM, Davison SN. Withholding and withdrawal from dialysis:what we know about how our patients die[J]. Semin Dial, 2007, 20(3):195-199.
15. 吳峰芬, 季曉英, 邱曉園, 等. 不同透析方式對山區透析患者生活質量的影響及相關因素分析[J]. 浙江醫學, 2013, 35(19):1746-1747, 1751.

West China Medical Journal

A Study of the Effective Model of Combination Management of Tertiary Hospitals and Community Hospitals for Home Peritoneal Dialysis Patients

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