MÔ HÌNH QUẢN LÝ BỆNH MẠN TÍNH KHÔNG LÂY TẠI PHÒNG KHÁM BÁC SĨ GIA ĐÌNH BỆNH VIỆN LÊ VĂN THỊNH

Abstract

Background: Along with the country's economic development, there is an increase in chronic non-communicable diseases, especially among the elderly, increasing the burden on the overloaded health system. Developing family medicine and managing chronic non-communicable diseases at the primary health facility are the actual policies of the National Health Department. Objective: Describe the management of chronic non-communicable diseases for the elderly at the Family Doctor Clinic of Le Van Thinh Hospital. Research objects and methods: Includes 2 parts: 1) Qualitative: describes the development and application of family medicine principles at the clinic; 2) Quantitative: statistics on the number of elderly people visiting the Family Doctor Clinic and specialty referral management for patients with chronic non-communicable diseases. Results: The clinic successfully applies a number of Family Medicine principles and continues to expand in size and staff. The compliance for follow-up schedule  in patients with common chronic diseases was low Hospitalization and transfer rates were 0.7% and 0.6%, respectively. About half of hospitalized patients and two-thirds of transferred patients still follow treatment at our clinic. Most patients achieved treatment goals. Conclusion: Management of common chronic non-communicable diseases for the elderly at the Family Doctor Clinic of Le Van Thinh Hospital was being implemented effectively. However, the coordination in patient transferring had not been as expected.