Chronic diseases are public health problems threatening human health, including hypertension, diabetes, stroke, coronary heart disease pressure, etc. They are common chronic diseases with high incidence rate, high mortality, high disability rate, low awareness rate, low control rate, and low treatment rate. "Prevention outweighs treatment in chronic disease management. However, in some remote areas, villagers themselves do not pay enough attention, inspection is troublesome, and it is difficult to see a doctor. In addition, due to the lack of resources for doctors, the prevalence of chronic diseases is on the rise, and the patient base is also expanding.". Conventional chronic disease management mainly relies on patient self testing, and there are many problems such as non-standard operation, aging equipment, forgotten measurement, irregular measurement time, and lack of long-term records, which make it difficult to effectively implement chronic disease management. However, it is time-consuming and costly to register and queue up for hospital inspections. Therefore, many patients with chronic diseases gradually have to "ignore chronic diseases".

近兩年，隨著國家對基層醫療的重視與投入，分級診療體系逐步建設深入，各大社區衛生服務中心正在逐步建立慢病管理制度，建立社區慢病防治網絡，對社區高危人權和重點慢病定期篩查，掌握病患情況，建立信息檔案庫，同時對人群重點慢病分類監測、登記。不少地區的村醫、家庭醫生建立了慢病隨訪制度，定期上門診療，為健康促進和干預提供良好基礎。

In the past two years, with the attention and investment of the country in primary health care, the hierarchical diagnosis and treatment system has gradually deepened. Major community health service centers are gradually establishing a chronic disease management system, establishing a community chronic disease prevention network, regularly screening high-risk human rights and key chronic diseases in the community, grasping the situation of patients, establishing an information archive, and classifying, monitoring, and registering key chronic diseases in the population. Village doctors and family doctors in many regions have established a follow-up system for chronic diseases, providing regular on-site diagnosis and treatment, providing a good foundation for health promotion and intervention.

公共衛生隨訪設備，便攜易用，為村醫、家庭醫生等打通慢病管理最初的百米，隨時隨地進行基礎健康數據快速檢測及收集，同時生成健康管理檔案，讓慢病患者都能享受到快捷的健康管理服務，提高醫護人員工作效率。

Public health follow-up equipment is portable and easy to use, providing village doctors, family doctors, and others with the initial 100 meters of chronic disease management. It can quickly detect and collect basic health data anytime, anywhere, and generate health management files, enabling patients with chronic diseases to enjoy fast health management services, improving the work efficiency of medical personnel.

檢測結果可上傳至上正華瑞健康管理云平臺，便于慢病管理及院外管控。有效助力慢病管理公共衛生隨診包，具有無線數據傳輸功能，便于收集各項健康檢測生理參數，生成健康評估報告并建立健康管理檔案，集數據收集、健康分析、電子病歷為一體，便于醫護工作人員及時給慢病患者提供健康管理建議，有效協助院外慢病干預及慢病健康管理。

The test results can be uploaded to the Shangzheng Huarui Health Management Cloud Platform to facilitate chronic disease management and out-of-hospital control. Effectively assist in the management of chronic diseases. The public health follow-up package has a wireless data transmission function, facilitating the collection of various physiological parameters for health testing, generating health assessment reports, and establishing health management archives. It integrates data collection, health analysis, and electronic medical records, facilitating medical staff to provide timely health management advice to patients with chronic diseases, and effectively assisting in the intervention and health management of chronic diseases outside the hospital.

地方衛計委：公衛服務、統計分析、對管轄設備和醫生進行排班、管理、監督指導。對轄區居民健康檔案進行管理分析，實現上下轉診、急慢分治等管理全科醫生：居民健康管理、健康檔案：對居民進行健康建檔、檔案管理：根據居民情況制定隨訪計劃、慢病管理計劃、孕產健康管理計劃等

Local Health and Family Planning Commission: public health services, statistical analysis, scheduling, management, supervision and guidance of equipment and doctors under its jurisdiction. Manage and analyze the health records of residents in the jurisdiction, and achieve management such as referral, emergency and chronic treatment. General practitioners: residents' health management, health records: establish health records for residents, file management: develop follow-up plans, chronic disease management plans, maternal and maternal health management plans, etc. based on the situation of residents

更多的關于慢病隨訪管理系統問題或者詳細的內容，請進入我們公司的網站：http://www.dgdw01.cn網站中會有很多的內容僅供參考。

For more questions or detailed information about the chronic disease follow-up management system, please visit our company's website: http://www.dgdw01.cn There will be a lot of content on the website for reference only.