Study On CVD Prevention Appropriate Technology In Health Screening Based On Patient-Centered Diagnosis And Treatment Mode

Objectives: As the prevalence and mortality of cardiovascular diseases(CVD)on the rise in China,it is imperative to pay attention to the prevention and management of CVD.A new health managementfor patients with "patient-centered,CVD prevention as the goal",accompanied by the implementing of Family Doctors Contracted Service,is being provided by family doctors and their teams in recent years for more and more residents under the framework of the new medical service model.On the whole,however,some deficiencies such aspatient management with multiple risk factors of CVD,which is lack of standardization and thus dissatisfy the requirement of family doctors and their teams,are to be further improved.Based on the current situation of CVD prevention,this study aims at screening and evaluating appropriate technologiesapplicable to family doctors and their teams for CVD prevention,laying a foundation for the promotion and extension of patient-centered CVD prevention technology in primary care.Methods: Research methods including documentary study method,focus group discussion method,judgement of expert individual method,delphi method and comprehensive evaluation method,along with the patient-centered diagnosis-treatment modelis used to form appropriate techniques for Patient-centered Prevention of Cardiovascular Diseases in primary care.The technology list is mainly constructed through documentary study method and focus group discussion method;Technical screening is mainly made through delphi method;The appropriate evaluation of technology is implemented by comprehensive comprehensive evaluation method.All data were stored in Microsoft Excel 2010 and analyzed by SPSS22.0software.Results: The study constructed patient-centered CVD prevention appropriate technology list on the basis of documentary study of 69 guides.Thirteen experts from general medicine,cardiovascular medicine were selected to construct the index system of appropriate technology in primary care including five parts—scientific,effective,universal,economic and demand,whose weight coefficients are0.2051:0.2017:0.2052:0.1963:0.1917,respectively.Twenty-four experts from general medicine,cardiovascular medicine,public health and mental health were selected for two rounds of Delphi expert consultation.After calculation,experts’ positive coefficient of the frist round of expert consultationis 91.67%,experts’ positive coefficient of the second round of expert consultation is 100%,experts’ authoritative coefficient is 0.92 and the coefficient of variation of each item is less than 0.3.At last,we form 25 appropriate patient-centered technologies for CVD prevention,which is composed of four parts: inquiry and examining,earlyrecognition and evaluating,joint decision-making and standardized treatment,disease management and long term follow-up.The comprehensive evaluation of appropriate technologiesfor CVD prevention and management in primary care shows that top three technologies are medical history collection and physical examination,recognition and referral techniques for acute patients and patient reception of general practice.Conclusions: Guided by the "patient-centered" diagnosis-treatment model,this study aims at screening and evaluating the appropriate technologies for CVD prevention and management,andthereby provides technical support for general practitioners and their teams to adapt to the new medical environment.