This paper introduces the background and research design (including site of investigation, study population, baseline survey and follow-up monitoring), which belongs to the Precision Medicine Project of the National Key Research and Development Program of China.
Patients with chronic diseases usually face severe challenges during their transition from hospital to home, such as poor discharge preparation, the increased incidence of medical errors, insufficient self-care capability, and poor participation in healthcare decision, which can result in increased readmission and poor patient safety. This paper reviews the definition of transitional care, single-element transitional care intervention strategy, and multiple-element transitional care intervention strategy, in order to provide new insights into the development of effective and safe transitional care strategies in China.
ObjectiveTo systematically review the efficacy of discharge preparation service in elderly patients with chronic diseases.MethodsCNKI, WanFang Data, VIP, Web of Science, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect randomized controlled trails (RCTs) on the discharge preparation service for elderly patients with chronic diseases from January, 2000 to January, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 7 RCTs, involving 884 patients were included. The results of meta-analysis showed that: after the hospitalization preparation service, the incidence of acute complication (RR=0.38, 95%CI 0.15 to 0.98, P=0.04), patient compliance behavior (SMD=0.54, 95% CI 0.25 to 0.83, P=0.000 3), exercise capacity (SMD=2.65, 95%CI 0.25 to 5.04, P=0.03), and nursing satisfaction (SMD=0.71, 95%CI 0.10 to 1.33, P=0.02) significantly improved. However, there were no significant differences in emergency hospital admission for acute complications (RR=0.25, 95%CI 0.06 to 1.11, P=0.07), self-care ability (SMD=2.18, 95%CI −1.02 to 5.38, P=0.18), activity of daily living (ADL) (SMD=0.56, 95%CI −0.47 to 1.59, P=0.28).ConclusionsThe current evidence shows that after implementation of the discharge preparation service, the incidence of acute complication, compliance behavior, exercise ability, and service satisfaction of the elderly patients with chronic diseases are significantly improved. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.
At present, the health management of chronic diseases in China is still in its infancy. In the face of an increasingly large group of patients with chronic diseases, large general public hospitals often lack a systematic and standardized chronic disease continuity management system. In order to solve the problem of patients’ medical difficulties, popularize the hospitals’ innovative medical services, and promote the professional development of clinical departments, taking the continuous health management model of chronic diseases constructed by West China Hospital of Sichuan University as an example, this paper introduces the background, organizational structure and service process of the system construction in turn. The purpose is to build a new health service model of “smart hospital”, and also provide a reference for the construction of standardized chronic disease management system in hospitals, which will lay a foundation for further constructing a top-down chronic disease whole process system linked with communities and hospitals in the later stage.
The prevention and control of chronic diseases is a major need that urgently needs to be solved in China. Traditional Chinese medicine has unique advantages in preventing and treating chronic diseases. However, insufficient patient engagement may be found in the selection and evaluation of traditional Chinese medicine for the prevention and treatment of chronic diseases. In recent years, patient-centered clinical research has become a hot topic. A patient-centered methodological framework is proposed for the selection and evaluation of traditional Chinese medicine for preventing and treating chronic diseases. It incorporates some patient-centered studies based on the evidence-based medicine practice model, and will provide a scientific basis for screening traditional Chinese medicine for preventing and treating chronic diseases, improving the efficiency of traditional Chinese medicine services, improving price policies, and updating medical insurance catalogs.