| Objective: Through the construction of rural medical institutions of cardiac remote monitoring network platform, can effectively prevent acute cardiovascular events, decrease the incidence and mortality of cardiovascular diseases in China, at the same time it can enhance and improve the level of health services of rural primary medical institutions and it not only can solve the contradiction of difficulty of getting medical service partially by saving medical resources to serve more people, but also can explore a new way for the information construction of grassroots medical institutions in rural areas of China; at the same time through the follow-up on patients with cardiovascular, in order to collect statistics of medical expenses, times of hospitalization, outpatient times, change of ECG data, we rely on remote ECG monitoring means and data mining analysis, giving intervention guidance in time, to study on the relationship between cardiovascular the event rate, mortality and medical expenses.Methods: Based on the construction of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine of cardiac remote monitoring network platform as a blueprint, sketch the construction steps, software facilities, hardware facilities, organization of personnel structure, management mode, operation flow to build the heart remote monitoring network platform. Between May to December 2013 were collected in the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine and Cardiovascular Hospital Department of cardiology out patient and inpatients at the grass-roots level in rural areas of cardiovascular disease in patients with 100 cases, using the method of randomized, divided into experimental group and control group with 50 cases in each group, the test group wearing of cardiac remote monitoring apparatus, the control group did not wear of cardiac remote monitoring apparatus,tracking follow up of 1 years. Collecting statistics of two groups of patients in, drug costs, the outpatient times, test fees, inspection fees, times of hospitalization, the hospitalization time, hospitalization-fees, through data mining, compare the relationship between changes of ST segment and cardiovascular events occurrence times.Results: As of 2014.12 at the beginning of 6, a total of 12 lead ECG monitoring mechanism to upload the information data of 1062 cases, there were 432 cases of which there is abnormal, the abnormal rate was 40.67%. Detection of abnormal ECG before five is: ST-T change(38.9%),sinus Heartbeat bradycardia(12.5%), atrioventricular block(8.8%), complete right bundle branch block(7.16%), incomplete right bundle branch block(5.55%), including 252 cases with a variety of ECG abnormal, 41 information recording adverse, unable to issue a report. ECG monitoring in all patients, the male 328 people(30.88%), abnormal ECG information 107(32.62%); 734 female passengers(69.11%), abnormal ECG information 325(75.23%); by detecting the youngest 21 years old, the oldest was 92 years old, average age 61.19 + 10.02 years old. Hospital monitoring center data show that more than 80% of the patients with abnormal ECG symptoms can be rest, take drugs under control; around 15% of patients need again to monitor or further examination to confirm the diagnosis given treatment; below 5%patients need to be immediately sent to hospital for treatment, of which more than half of the patients required hospitalization. Through the 120 emergency turn in 13 cases, 7 cases of acute coronary syndrome, rushed to hospital monitoring center after treatment, symptoms improved, 6 patients with paroxysmal a trial fibrillation, symptomatic improvement after treatment. ECG diagnosis results suggest that patients need further examination confirmed the diagnosis of 63 cases were treated with.The test group and control group, the experimental group drug costs reduced, there is significant difference(P <0.05); outpatient number decreased,no significant difference(P >0.05); testing and inspection cost reduced, no significant difference(P > 0.05); the times of hospitalization was reduced, there is significant difference(P <0.05); hospitalization time is shortened, there is significant difference(P < 0.05); hospitalization expenses decreased significantly, with significant difference(P < 0.01); the incidence of cardiovascular events is reduced, there is significant difference(P<0.05); death less than the control group, but it is not statistically significant. Also found through data mining, the test group the change of ECG ST segment, there is a corresponding relationship with the rate of cardiovascular events, ST segment depression was less than 0.05 mv, no correlation with cardiovascular events; when the ST segment depression greater than or equal to 0.05 mv, was positively associated with cardiovascular events.Conclusion:(1) rural patients with cardiovascular disease by cardiac remote monitoring can significantly reduce the frequency of hospitalization, shorten the hospitalization time, and can reduce the number of cardiovascular events in patients with cardiovascular disease, improve the quality of life, so as to relieve social pressure caused by abnormality and disability due to cardiovascular disease, and to alleviate the medical problem of difficulty to see a doctor.(2) rural patients with cardiovascular disease by cardiac remote monitoring can reduce the cost of hospitalization expenses and daily medication, significantly reduce the heavy economic burden of patients with cardiovascular disease, so as to alleviate the "high cost" medical problem.(3) Rural cardiovascular patients with cardiovascular events, Angina pectoris attacks is in the majority, cardiovascular events and hospitalization have to do with ST segment depression, when the ST segment is not less than 0.05 mv, with ST segment depression intensifies, cardiovascular events and the number of hospital number increases gradually.(4) by constructing remote cardiac monitoring network in rural grassroots medical institutions, to improve the medical technology, alleviate the social status of medical treatment is difficult and expensive ", are of great significance. |
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