Meta-analysis of Clinic Results of Two-Way Referral of Hypertension Patients in China
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摘要: 目的 系统评价我国高血压患者在实施双向转诊干预之后的临床结局,为高血压患者双向转诊的推广提供依据。 方法 计算机检索PubMed、Embase、Cochrane library、CNKI、VIP、CBM和Wan-fang data等数据库,检索时限均为建库至2016年9月,收集所有实施双向转诊干预措施与常规入院的高血压病例对照研究,按照JBI质量评价标准纳入病例对照研究,提取有效数据并采用RevMan 5.3软件进行Meta分析。 结果 最终纳入7篇病例对照研究,共计1 639人,实施双向转诊途径838人,未实施双向转诊801人。与未实施双向转诊的高血压患者比较,实施双向转诊的高血压患者就诊时间[MD=-0.89,95%CI(-0.90,-0.88)]和平均住院日[MD=-2.04,95%CI(-2.18,-1.90)]明显缩短,再就诊率[OR=0.16,95%CI(0.11,0.23)]和医疗费用[MD=-302.52,95%CI(-309.06,295.97)]明显降低,差异有统计学意义(P<0.01);虽然治疗有效率较高[OR=2.29,95%CI(0.78,6.74)],但差异无统计学意义(P>0.05)。 结论 高血压患者通过双向转诊干预能有效节约就诊时间、缩短平均住院日、减少再就诊率和降低医疗费用,但对治疗效果无影响。Abstract: Objective To systematically evaluate and integratively analyze the relevant literature about the Clinic Results of Two-way referral of hypertension patients in China for providing evidence for two-way referral of hypertension patients. Methods The relevant literature which included Clinic Results of Two-Way Referral of Hypertension Patients in China were systematically retrieved from the datebases of PubMed,Embase,Cochrane library,CNKI,Wan Fang data,VIP and CBM to September in 2016.After the quality of literatures was evaluated according to JBI standard,the data effectively extracted and analyzed with RevMan 5.3 software. Results Totally 7 case-control studies were conducted,involving 1 639 people,including 838 cases received and 801 cases not received two-way referral.Compared with hypertension patients who not received two-way referral,the visiting time[(MD=-0.89,95%CI(-0.90,-0.88)]and average length of stay hospital[(MD=-2.04,95%CI(-2.18,-1.90)]were significantly shorten,twice visiting rate[(OR=0.16,95%CI(0.11,0.23)]and medical expense[(MD=-302.52,95%CI(-309.06,295.97)]were significantly reduced in hypertension patients who received two-way referral (P<0.01).Although the efficiency ratio of treatment[OR=2.29,95%CI(0.78,6.74)]were higher in hypertension patients who received two-way referral,but there wasn't statistical significance (P>0.05). Conclusion Hypertension patients who received two-way referral to intervene can save visiting time,shorten average length of stay hospital,reduce twice visiting rate and low down medical expense,but there are no effect on the therapeutic efficiency ratio.
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Key words:
- Two-way referral /
- Hypertension /
- Systematic review /
- Meta analysis
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