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【国家卫建委】依托区域信息平台,做好新冠肺炎出院患者健康管理。

发布时间:2020-03-15 00:56:30 阅读:1,193次 发布者:姜蕾蕾

随着治愈出院患者的不断增多,为做好出院患者的隔离管理、随访复诊、健康监测、康复管理等一揽子工作,促进新冠肺炎全流程管理、促进患者全面康复,3月13日,国家卫生健康委发布了《新冠肺炎出院患者健康管理方案(试行)》。

 

​新冠肺炎出院患者健康管理方案(试行)
  为进一步做好新冠肺炎患者治愈出院后的隔离管理、随访复诊、健康监测、康复医疗等工作,实现全流程管理,促进出院患者全面康复,特制定本方案。

一、职责分工
  各地卫生健康行政部门要加强对新冠肺炎患者出院后健康管理的统筹协调,定点医院、隔离场所、康复医疗机构、基层医疗机构密切配合,加强信息沟通,协同做好新冠肺炎患者出院后隔离管理、随访复诊、健康监测、康复医疗等工作。新冠肺炎患者治愈出院后,应当继续隔离进行14天医学观察和健康管理。

二、出院前准备
  定点医院要严格执行《新型冠状病毒肺炎诊疗方案(第七版)》出院标准和出院后注意事项。患者出院前要对其临床症状、体征、实验室与影像学检查结果等综合评估,明确后续跟踪随访事项。要为出院患者安排好2~4周的随访复诊计划。
三、出院交接
  出院后以居家隔离为主。定点医院要及时将出院患者信息推送至患者辖区或居住地居委会和基层医疗机构,基层医疗机构要指导出院患者及家属按要求做好隔离管理和自我健康监测。湖北省武汉市等设有集中隔离点的地区,卫生健康行政部门要指导定点医院与集中隔离点、基层医疗机构做好衔接。
  
四、隔离管理
  出院患者应进行严格居家隔离,尽可能居住在通风良好的单人房间,并减少与家人的密切接触。做到分餐饮食,做好手卫生和日常清洁,避免外出活动。湖北省武汉市等设有出院患者集中隔离点的地区,隔离期间要做好出院患者医学观察、康复、照护等服务。
  
五、出院后随访复诊和健康监测  
出院患者要按照复诊计划在定点医院进行复诊,一般在患者出院后第2周、第4周进行。各有关医疗机构和集中隔离点要密切关注出院患者健康状况,对老年人和有基础疾病的出院患者要特别加强健康状况监测,一旦发现出院患者出现发热、咳嗽等临床表现,应尽快将其转至定点医院进一步治疗。
  
六、康复管理
  各地要结合本地实际,按照《新冠肺炎出院患者康复方案(试行)》要求提供康复医疗服务。在患者较为集中的地区要安排基层医疗机构承担社区康复任务。
  
七、应用信息技术和平台
各地要依托区域卫生信息平台,努力做到居民健康档案、电子病历、出院健康监测等信息共享和业务协同,实现新冠肺炎患者临床诊治与健康管理的无缝衔接。全科医生和乡村医生要通过家庭医生签约APP、有线电视网络等多种手段与辖区内管理的出院患者开展信息互动,通过“互联网+”等形式,为出院患者提供健康管理服务。
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freemarker.core.BodyInstruction.accept(BodyInstruction.java:60) at freemarker.core.Environment.visit(Environment.java:366) at freemarker.core.Environment.invokeNestedContent(Environment.java:618) at freemarker.core.BodyInstruction.accept(BodyInstruction.java:60) at freemarker.core.Environment.visit(Environment.java:366) at freemarker.core.Environment.invoke(Environment.java:775) at freemarker.core.UnifiedCall.accept(UnifiedCall.java:83) at freemarker.core.Environment.visit(Environment.java:366) at freemarker.core.Environment.invoke(Environment.java:775) at freemarker.core.UnifiedCall.accept(UnifiedCall.java:83) at freemarker.core.Environment.visit(Environment.java:330) at freemarker.core.Environment.visit(Environment.java:336) at freemarker.core.Environment.process(Environment.java:309) at freemarker.template.Template.process(Template.java:384) at org.springframework.web.servlet.view.freemarker.FreeMarkerView.processTemplate(FreeMarkerView.java:389) at org.springframework.web.servlet.view.freemarker.FreeMarkerView.doRender(FreeMarkerView.java:302) at org.springframework.web.servlet.view.freemarker.FreeMarkerView.renderMergedTemplateModel(FreeMarkerView.java:253) at org.springframework.web.servlet.view.AbstractTemplateView.renderMergedOutputModel(AbstractTemplateView.java:178) at org.springframework.web.servlet.view.AbstractView.render(AbstractView.java:316) at org.springframework.web.servlet.DispatcherServlet.render(DispatcherServlet.java:1371) at org.springframework.web.servlet.DispatcherServlet.processDispatchResult(DispatcherServlet.java:1117) at org.springframework.web.servlet.DispatcherServlet.doDispatch(DispatcherServlet.java:1056) at org.springframework.web.servlet.DispatcherServlet.doService(DispatcherServlet.java:942) at org.springframework.web.servlet.FrameworkServlet.processRequest(FrameworkServlet.java:1005) at org.springframework.web.servlet.FrameworkServlet.doGet(FrameworkServlet.java:897) at javax.servlet.http.HttpServlet.service(HttpServlet.java:634) at org.springframework.web.servlet.FrameworkServlet.service(FrameworkServlet.java:882) at javax.servlet.http.HttpServlet.service(HttpServlet.java:741) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:231) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.apache.tomcat.websocket.server.WsFilter.doFilter(WsFilter.java:53) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at com.github.xiaoymin.swaggerbootstrapui.filter.SecurityBasicAuthFilter.doFilter(SecurityBasicAuthFilter.java:84) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at com.github.xiaoymin.swaggerbootstrapui.filter.ProductionSecurityFilter.doFilter(ProductionSecurityFilter.java:53) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.apache.shiro.web.servlet.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:112) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.apache.shiro.web.servlet.ProxiedFilterChain.doFilter(ProxiedFilterChain.java:61) at org.apache.shiro.web.servlet.AdviceFilter.executeChain(AdviceFilter.java:108) at org.apache.shiro.web.servlet.AdviceFilter.doFilterInternal(AdviceFilter.java:137) at org.apache.shiro.web.servlet.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:125) at 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org.springframework.web.filter.HiddenHttpMethodFilter.doFilterInternal(HiddenHttpMethodFilter.java:93) at org.springframework.web.filter.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:118) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.springframework.web.filter.CharacterEncodingFilter.doFilterInternal(CharacterEncodingFilter.java:200) at org.springframework.web.filter.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:118) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.apache.catalina.core.StandardWrapperValve.invoke(StandardWrapperValve.java:202) at org.apache.catalina.core.StandardContextValve.invoke(StandardContextValve.java:96) at 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