Service profile

1. (context)

() :

() :

8.00 16.00 .
1.

2.
3.
4.

5.
6.

: one stop service

, 1

1. 1 1

2.

3. 12.00

13.00 .

1. 1
2.

3.
08.00 -16.00 .

4.

1.
(
)

2.

3.

-
1. IT
2.

IT

3.

4.

() (
)

1.

2.

3. ..

-
(

/ )

- /

(
)

-
-

-
-

-
-

-
-

-


-

-
-

Hypoglycemia, Hyperglycemia, MI, Cerebral

vascular accident

-
- Admit
-

- HN

- .. /
.. -

case

-
-

X-rays

-
-

-
-

-
-

- stroke DM Foot

- ( ,
ASA )

-
-

-
- visit

- visit
() :

()

1.
120 /

2.

3.

4.

2553 1
3
(MI)

- 1
ER

- 2

()

- 3

2
-

2554 3

-Acute stroke 2

-Acute MI 1

1.

2.

3.
4.

5. /

() ( )
1.

- ()
- ()
- ()
- (
)
-
()
- ()
- ()
- (
)
2.

2552
3,162
410

4.12

258.65
3,159
438

6.02

276.32

2553

7,010
469

4.42

2554
3,762
495

295.8
364

4.66

229.6

4,888
489

3.

2
5
2
1

1.

Program IMED

2. Digital

4.

1. Computer
IMED

2. Print
3.
Digital

4.

Manual

5. Digital

6. DTX
7.

2
4

1
-

1
1

2
4

2
1

8.

9. -

10.
(Key process)

(Key process)

(Process Requirement)

(Performance
Indicator)

1.

- ,

/
-

-

- ,

(Key process)

2.

(Process Requirement)

(Performance

Indicator)
-
-

-

-

3.

-
-

- /

1
4.

Admit 28
- Admit
HypoHyperglycemia

5.


(Key process)

6.

(Process Requirement)

(Performance

Indicator)
- -

70-130 mgldl
70-130 mgldl

. 3 visit

.
-
(

140/90 (
)
mmHg
-
-

Hypoglycemia

Hyperglycemia

7.

-
HHC
-

-
HHC

, .



-

3. (Performance Indicator)

52 53 54

1.
0

2.

1 -

1.

2.

80%

NA

90

NA

80.8 80.0 -

2% 4%

NA

1.
50 % NA 26.2

3%

100 73%

2. %

81.2
0%

4
.
30

-

-

42.7 -

6%

-
83.1
1%

1.

2552
2553

<70%

FBS 70 130 mgldl

2.
3.
4.

< 5 /
Hypoglycemia +

> 80 %

56.50% 58.40

2554

66.70
%

Na

72.85

80.04

36.22% 54.44

70.62

> 70 %

> 70 %

Na

67.04

75.06

> 70 %

Na

73.00

71.52

%
%

%
%

5.

Na

38.62

79.15

>70 %

Na

58.56

84.72

- Lipid

>70 %

57.2%

63.40

78.36

LDL <

>70 %

45.91% 58.90

60.11

Microalbuminuria

7.

profile

100 Mgldl

DM foot

<5%

%
%
%
%

Na

Na

2552 255

1.

> 70 %

( Cr)

6.

< 140/90 mmHg

> 80 %

%
%
%
%

0.39%

2554

61.5 79.4 77.8

0%

0%

2%

2.

- FBS

- Bun , Creatinine
1

3.

- UA , Urine protein
1

( creatinine 1.5)

5.

-
-
-

7.

54.1 73.8 84.2

<5 %

12.4 6.80 4.88

0%

3%

- Lipid profile 1

4.

6.

> 80 %

> 80 %

Na

<1%

72.8 80.0
5%

4%

<10%
> 80%

Na

32.2 74.7
2%

7%

8.

> 80 %

68.0 76.7 81.2

0%

4%

8%

4.
4.1
(
)

1.

2.

NCD
.

120 /
-

-
6

/
-

DM HT

2552 DM 3162 HT
3159

2553 DM 7010 HT
2554 DM 3762 HT
4888
-
4.30 .
-

5 /

Hypoglycemia

-
2552

3.

Lad

1
-

1
-

DM-HT

2553

2554 3
-

>
80

- 2553
- 250

-
112

- 2554
-
157

-
74

100

4.2
4.2.1

1.

1.
( , , ,
, , , ,
- , )

2. visit
3.
4.
5.
6.
7.
8.

1.
80.82
2.

3. ( ,

 ,
)
2.

1.
1.1 ..

100%
1.2 .. 50%
1.3 F/U

CPG 90%

3. ..

???????E??E???????!?????!??????????
?E?????????????
FBS 70

130 Mg %

HbA1c 4.5
7.0

BP < 130/80
mmHg

TG , LDL
Normal %

Pcu

Pcu

CPG

..

Refer
??.??????!

????!??

?!??

?????E?? ??.??.

..

3.
3.1 .. 1
/1 ..
..
3.2 ..
BS < 70 Mg %

1.5 1.4

, Cr

BS > 300 Mg %

HbA1c > 8 %

BP > 150 / 90 mmHg

. 08

4. .

1.

2.

..

-
-

- Self health group /

-
-
-

-DTX

Bun Cr lipid profile

Hba1c Urine protein

-
-
-

-
-


1.
2.
3.
3.





1.

2. .
3.

4. /
5. PCT

1.

2.

5.

/

1.

2.

-
1 .

53-3

0 .
- .54

1 .
.
53-3
0 .
.54

1.

2.

3.

..

3.

4.

-


FBS3

00mg
%

100%

FBS2

00mg

50

1 .
.
53-3
0 .
.54

1 .
.
53-3
0 .
.54

5.

6.

Hypo/Hpe

rgly

cemia

HHC

Hypo/

Hpergl
3
y

1 .
.
53-3
0 .
.54

- 1 .

.
53-3
FBS 0 .
.54
300

cemia

FBS

300m

g%

mg%