关键词: 医联体, 专全结合, 分级诊疗, 哮喘, 过敏性鼻炎

Abstract: Objective To explore the grading management and efficacy evaluation of children asthma complicated with allergic rhinitis under medical alliance model of "combination of general practice with specialties". Methods Totally 220 cases of patients with children asthma complicated with allergic rhinitis who received treatment in Shibei Hospital from January to December 2017 were randomly divided into two groups.All patients were referred to the community health service center for health management after their condition was stable.Control group(n=110) was given the conventional extension management model to provide health education, medication guidance and lifestyle intervention and other services.And the children were referred up in time if the disease was aggravated.Research group(n=110) was given standardized management based on general-specialist in medical alliance including establishing disease management team, standardizing diagnosis and treatment path, improving drug catalog and testing function and hierarchical management.The control of asthma and allergic rhinitis and the recognition and satisfaction of parents between two groups were compared and analyzed. Results After 6-month management, the C-AT score [(24.61±2.62)vs.(20.30±2.97)],level of PEF[(91.32±5.23)% vs.(78.12±4.48)%]in the study group was significantly increased, and the score of allergic rhinitis [(0.93±0.25) vs.(2.04±0.42)] was significantly decreased, which was significantly better than that in the control group(P<0.05).The number of acute asthma attacks[(2.14±0.32) time vs.(2.59±0.37)time], length of hospital stay[(8.76±0.85) d vs.(9.41±1.31)d] and medical expenses[(5 028.71±1 037.30) yuan vs.(6 273.20±1 739.41)yuan] in the study group were significantly reduced, the parents of the children in the study group showed a significant increase in their recognition(93.6% vs.85.5%) and satisfaction with the service(91.8% vs.82.7%)compared with the control group(P<0.05). Conclusion Grading management of children asthma complicated with allergic rhinitis in medical alliance model based on general-specialist in medical alliance helps to optimize the allocation of medical resources, realize the homogenization management of hospitals and communities, and has positive significance for the disease control of children and patients′ satisfaction.

Key words: medical alliance, general-specialist, hierarchical diagnosis, asthma, allergic rhinitis