养老机构术后远程医养结合体系的构建及评价

  目的  为养老机构术后患者构建远程医养结合体系，并分析其应用价值。  方法  2018年1月—2021年6月，招募50例养老机构老年术后患者，按3∶ 2的比例随机分成实验组(30例)和对照组(20例)。实验组出院后接受远程医养结合体系服务，对照组则按传统方案分别接受“医”和“养”的服务。出院1个月后，分别评价2组的就诊次数、医疗费用、术后恢复情况、焦虑抑郁及满意程度。  结果  实验组的就诊次数较对照组少0(0，1)次vs. 1(0，2)次，Z=-2.133，P=0.033]。2组的医疗费用差异无统计学意义0(0，138.93)元vs. 112.20(0，291.70)元，Z=-1.413，P=0.158]。实验组无切口感染患者，对照组有1例，2组差异无统计学意义(χ2=1.531，P=0.216)。2组均无切口出血、切口裂开、再入院及再手术患者。2组间的体力状况差异无统计学意义(72.33±9.35)分vs. (70.00±9.18)分，t=0.871，P=0.388)。2组间的体重变化差异无统计学意义1.20(0.30，1.73)kg vs. 0.75(0.10，1.10)kg，Z=-1.737，P=0.082]。实验组的焦虑、抑郁得分均较对照组低(35.04±7.36)分vs. (39.69±8.08)分，t=-2.103，P=0.041；(37.92±7.22)分vs. (42.88±6.46)分，t=-2.477，P=0.017]。实验组对医疗服务、心理慰藉、科普宣传及日常照护的满意程度均较对照组高(均P < 0.05)；2组对文化娱乐的满意程度差异无统计学意义(P>0.05)。  结论  远程医养结合体系能够为养老机构老年术后患者提供更好的医疗服务，如减少就诊次数、提供更好的心理慰藉及更好的科普宣传等，同时也能促进日常照护的完善。 

Construction and evaluation of remote integrated medical care and pension service system for postoperative patients in pension institutions

  Objective  To construct a remote integrated medical care and pension service system for postoperative patients in pension institutions and analyze its application value.  Methods  A total of 50 postoperative patients who were ready to go back to pension institutions were recruited from January 2018 to June 2021, and randomly divided into experimental group (30 cases) and control group (20 cases) according to the ratio of 3∶ 2. After being discharged, the experimental group received remote integrated medical care and pension services, and the control group received medical care and pension services according to traditional scheme. One month after discharge, the number of visits, medical expenses, postoperative recovery, anxiety, depression and satisfaction levels were evaluated.  Results  The number of visits of the experimental group were less than that of the control group 0(0, 1) vs. 1(0, 2), Z=-2.133, P=0.033]. No significant difference in medical expenses was found between the two groups 0 (0, 138.93) yuan vs. 112.20 (0, 291.70) yuan, Z=-1.413, P=0.158]. There was no wound infection in the experimental group and 1 case in the control group, with no significant difference (χ2=1.531, P=0.216). There were no patients with incision bleeding, incision dehiscence, readmission and reoperation in the two groups. There was no significant difference in physical strength between the two groups (72.33 ± 9.35) points vs. (70.00 ± 9.18) points, t=0.871, P=0.388]. There was no significant difference in weight change between the two groups 1.20 (0.30, 1.73) kg vs. 0.75 (0.10, 1.10) kg, Z=-1.737, P=0.082]. The anxiety and depression scores of the experimental group were lower than that of the control group (35.04±7.36) points vs. (39.69±8.08) points, t=-2.103, P=0.041; (37.92±7.22) points vs. (42.88±6.46) points, t=-2.477, P=0.017]. The experimental group had higher satisfaction with medical services, psychological comfort, science popularisation and publicity and daily care than the control group (all P < 0.05). No significant difference in cultural entertainment satisfaction was detected between the two groups (P>0.05).  Conclusion  The remote integrated medical care and pension service system can provide efficient medical services for postoperative patients in pension institutions, such as reduced number of medical visits, better psychological comfort and science popularisation and publicity, and can also promote the improvement of daily care.