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本文描述波多黎各圣胡安市爱滋病防治的综合模式并与传统的以医院为基础的医疗制度作了比较。在现行资金分配不变的条件下,这一综合模式强调预防、教育、监测、早期发现、门诊治疗以减少住院治疗。1987年(执行传统医疗制度的最后一年)爱滋病患者住院治疗95人次,1988年(实行综合规划的第一年)住院治疗100人次。平均住院时间由1987年的22.3天缩短到1988年的11.3天——缩短了46.8%(P=0.001)。每一患者的年平均(SE)住院费由1987年的15118美元(1699)降至1988年的3869美元(659)。节省下的资金被用于非住院治疗,包括扩大医疗网点、教育、急诊与门诊治疗、化验及流行病学服务、研究工作以及实行医务人员奖励计划等。这些旨在缩短住院治疗时间,提供较便宜的医疗手段的管理策略可用于发展中国家以改进爱滋病防治工作。
This article describes the comprehensive model of AIDS prevention and control in San Juan, Puerto Rico and compares it with the traditional hospital-based healthcare system. With the current allocation of funds unchanged, this comprehensive model emphasizes prevention, education, monitoring, early detection, and outpatient treatment to reduce hospitalization. In 1987 (the final year of the implementation of the traditional medical system), AIDS patients were hospitalized 95 times, and in 1988 (the first year of comprehensive planning) hospitalization was 100 times. The average length of stay was reduced from 22.3 days in 1987 to 11.3 days in 1988 - a 46.8% reduction (P=0.001). The annual average (SE) hospitalization fee per patient decreased from $15,118 (1699) in 1987 to $3,869 (659) in 1988. The saved funds are used for non-hospital treatment, including the expansion of medical outlets, education, emergency and outpatient treatment, laboratory and epidemiological services, research work, and implementation of medical personnel reward programs. These management strategies aimed at shortening hospitalization time and providing cheaper medical measures can be used in developing countries to improve AIDS prevention and treatment.