中医院的质量分析Kötzting——来自正在进行的系统化病人记录的例子。

Forschende Komplementarmedizin Pub Date : 2016-01-01 Epub Date: 2016-05-30 DOI:10.1159/000445009
Wolfgang Weidenhammer, Dieter Melchart
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引用次数: 5

摘要

背景:Bad中医院Kötzting自成立25年以来一直实行质量分析。分析包括治疗有效性和安全性、结构特征、工作人员资格以及诊断和治疗过程的评估。有关患者、干预措施和结果概况的研究结果通过适当的例子提出。方法:由医师系统收集每位住院患者入院、出院及随访时的自我报告资料。多年来,该系统经过多次调整,截至2014年底,数据池约有1.9万名住院患者。结果:患者平均年龄52岁,女性占70%,主诉时间为7年(中位数)。多年来,随着对心身焦点的发展,诊断谱发生了变化。中医针灸治疗在7.7个不同部位平均使用222个不同的穴位。主诉的平均强度与临床相关(出院时Cohen’s d = 1.11,随访时为0.93)。住院后,每个病人每年的病假天数从51.3天下降了40%。抑郁症作为最常见的精神疾病在出院时显著下降(ICD症状评分);Cohen’s d = -1.01)。根据国际糖尿病联合会(IDF), 29.8%的患者符合代谢综合征诊断标准。在这组病例中,甘油三酯、胆固醇和血糖在出院时明显改善。讨论:提出的质量控制措施显然有助于提高全面质量概况方面的透明度。各种结果参数的结果表明,患者受益于治疗。
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Quality Profiling at the TCM Hospital Bad Kötzting - Examples from an Ongoing Systematic Patient Documentation.

Background: Quality profiling is practiced at the TCM hospital Bad Kötzting since its establishment 25 years ago. The profiling comprises assessment of treatment effectiveness andsafety, structural features, staff qualification as well as diagnostic and therapeutic processes. Findings regarding patients, intervention and outcome profiles are presented by appropriate examples.

Methods: Data of each in-patient were systematically collected by physicians and via self-reports at admission, discharge and follow-up. Over the years the system was adjusted several times resulting in a data pool of about 19,000 in-patients by end of 2014.

Results: Patients are 52 years old on average, 70% are female, and suffering from the main complaint since 7 years (median). The diagnostic spectrum changed over the years according to the development towards a psychosomatic focus. For TCM acupuncture therapy 222 different acupoints were used in 7.7 different localisations on average per individual treatment. The mean intensity of the main complaint decreased clinically relevant (Cohen's d = 1.11 at discharge and 0.93 at follow-up). After the hospital stay the number of days of sick leave declined from 51.3 days by 40% per patient and year. Depressive disorders as most common mental illness decreased significantly decreased significantly at discharge (ICD symptom rating; Cohen's d = -1.01). 29.8% of patients met the criteria for a metabolic syndrome diagnosis according to the International Diabetes Federation (IDF). In this group of cases, triglycerides, cholesterol and blood glucose improved markedly at discharge.

Discussion: The presented quality control measures clearly contribute to an enhanced transparency in terms of a comprehensive quality profile. The findings from various outcome parameters indicate that patients benefit from the treatment.

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Forschende Komplementarmedizin
Forschende Komplementarmedizin 医学-全科医学与补充医学
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