1、哮喘行为模式与管理经验EOS 3.1%10152025ACT52009.10EOS 5.8%急性加重2010.12011.12012.12013.1未复诊preFEV1%per 90-95%之间preFEV1%per 71.5%未复诊急性加重依从治疗自行减量自行停药女性，23岁（2009）案例疾病管理：关注患者连续的健康状况和生活质量患者行为：患者心理的外在表现，是对付外界环境变化的手段 个人的行为是个体和环境交互作用的产物020406080100治疗诊断预防症状定义80%0未发表数据来自重庆12家医院，1582例哮喘患者Self-Report Adherence未发表数据2.80%2.30%
2、4.11%7.89%5.10%43.75%14.80%6.41%12.83%0.00%10.00%20.00%30.00%40.00%50.00%otherpreference for oral medicationinconvenience of treatmentdifficulty obtaining medicationoccurrence/fear of side effectsrelief of symptoms after short-term medication usepoor self-efficacydiminished treatment effectiveness w
3、ith long-term usehigh cost of medicationSelf-Report Adherence未发表数据哮喘的管理，对于医疗服务提供方来讲，付出远远大于直接的获益。不但需要工作人员的满腔热情，更需要大家的坚持和坚守。【医患伙伴关系】【健康素养】【医学信息】【疾病知识】【无法由患者单独完成】医生患者设备规范费用人员效率空间时间平台基于网络的疾病管理平台系统空间人员慢病管理核心团队门诊病房肺功能痰细胞学脱敏治疗医技护常规护理设备肺功能FeNo其他 支撑资源支撑资源 技术方案技术方案l可以支撑的资源（人、物、空间可以支撑的资源（人、物、空间)l可能支撑的资源（人、物、空间
4、可能支撑的资源（人、物、空间)l平台层面平台层面l医疗层面医疗层面l具体的具体的l实际的实际的 管理策略管理策略规范ChronicAirwayDiseaseCareCenterhttp:/:801平台效率网络化的管理平台规范化的过程管理基于细节的持续改进可用资源的合理整合1.71%35.04%64.10%8.64%70.34%20.99%0.00%10.00%20.00%30.00%40.00%50.00%60.00%70.00%80.00%控制部分控制未控制未管理管理 When I was young and free and my imagination had no limits,I d
5、reamed of changing theworld.As I grew older and wiser,I discovered the world would not change,so I shortened my sights somewhat and decided to change only my country.But it,too,seemed immovable.As I grewinto my twilight years,in one last desperate attempt,I settled for changing only my family,those
6、closest to me,but alas,they would have none of it.And now,as Ilie on my death bed,I suddenly realize:If I had only changed myself first,then by example I would have changed my family.From their in spiration and encouragement,I would then have been able to better my country,and who knows,I may have even changed the world.我们的宗旨：通过规范化管理平台，将最新研究进展应用于疾病管理，帮助患者持续获益的同时推进慢性气道疾病的研究，加深对疾病的认识和理解，促进疾病管理进步。
