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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1. Tesar V. The past, the present and the future of renal replacement therapy[J]. Vnitr Lek, 2011, 57(7-8):603-606.
2. 陈再彬. 国际与我国血液透析发展概况[J]. 健康向导, 2009, 15(3):12.
3. 薄天慧, 高秀, 赵伟, 等. 持续性非卧床腹膜透析患者低钾血症发生率与临床意义[J]. 华西医学, 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. 内科学[M]. 北京:人民卫生出版社, 2013:524-525.
6. 陈香美. 腹膜透析标准操作规程[M]. 北京:人民军医出版社, 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. 刘旭, 张东亮, 王刚, 等. 利用三级医疗体系推广腹膜透析社区化管理模式的初步研究[J]. 中国全科医学, 2012, 15(34):3972-3974.
9. 田疆, 季煦. 加拿大全科医生制度建设对中国的启示[J]. 中国全科医学, 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. 刘运杰, 王艳红, 张智勇, 等. 三级医院与社区医院住院患者双向转诊路径初探[J]. 中国全科医学, 2010, 13(7):701-703.
12. 么丽春, 刘俊青, 王路红, 等. 居家腹膜透析患者的社区管理探讨[J]. 中国全科医学, 2010, 13(22):2531-2532.
13. 肖月, 宋文舸, 赵琨. 新型农村合作医疗对透析服务管理现状研究[J]. 卫生经济研究, 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. 吴峰芬, 季晓英, 邱晓园, 等. 不同透析方式对山区透析患者生活质量的影响及相关因素分析[J]. 浙江医学, 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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