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——杨滢瑞 张红梅 夏梦婷 姚溪 黄冉冉 李晓华 张俊娟 卢跃峰
【摘要】组建糖尿病视网膜病变健康管理团队，根据河南省地域特点建立区域糖尿病视网膜病变诊疗联盟，依托人工智能技术形成高效筛查方法；结合信息技术构建健康信息平台，对糖尿病患者进行风险评估、健康教育、延续护理等健康管理；形成省级医院、县级医院、家庭三级联动的同质化诊疗方案。智能化筛查提高了筛查效率及覆盖率，信息化管理提高了筛查执行率及患者生活质量，区域化糖尿病视网膜病变健康管理有助于发挥各级医疗机构优势，降低糖尿病患者的致盲风险。
【关键词】品管圈；糖尿病视网膜病变；区域医疗；智慧医疗；健康管理
中图分类号：R197.323；R587.1文献标识码：B
Construction of Regional Intelligent Health Management Model for Diabetic Retinopathy/YANG Yingrui,ZHANG Hongmei,XIA Mengting,et al.//Chinese Health Quality Management，2020,27(5):93-97
AbstractA diabetic retinopathy health management team was set up, a regional diabetic retinopathy diagnosis and treatment alliance was set up based on the regional characteristics of Henan Province, and an efficient screening method was formed based on artificial intelligence technology.The risk assessment, health education, continuous care for diabetes patients were carry out by combining information technology to build a health information platform. A homogenized diagnosis and treatment program had been formed with the linkage of provincial hospitals, county hospitals and families. Intelligent screening had improved the screening efficiency and coverage rate, information-based management had improved the screening implementation rate and the quality of life of patients, and regional health management of diabetic retinopathy was conducive to giving play to the advantages of medical institutions at all levels and reducing the risk of blindness of diabetic patients.
Key words Quality Control Circle; Diabetic Retinopathy; Regional Medical Care; Intelligent Medical Treatment; Health Management
Firstauthor's address Henan Provincial People's Hospital, Zhengzhou,Henan,450000, China
1主题选定
圈员从重要性、迫切性、圈能力、领导重视程度、达成性5个维度，采用5-3-1打分法对5个备选主题进行评价，最终确定“构建区域内糖尿病视网膜病变智慧健康管理模式”为本期活动主题。经QC-Story判定，本期活动主题为课题研究型。
选题背景：糖尿病视网膜病变（Diabetic Retinopathy，DR）是长期高糖状态引起眼底微血管损害造成的视网膜病变。它会导致不同程度的视力损伤甚至失明，给家庭、社会带来沉重的经济负担［1-2］。国家《“十三五”眼健康规划》明确指出，早筛早防可有效降低DR致盲风险［3］。但有调查显示，主动进行糖网筛查的糖尿病患者仅占14.48%［4］。国外有些国家已初步形成以社区筛查为基础，以远程阅片为手段的糖网健康管理模式［5-8］。我国则因为眼科医师紧缺,机构间诊疗水平差异大，尚未形成统一的管理模式［9-10］。因此，探索高效、便捷的糖网管理模式具有重要意义。
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