慢病随访治理系统建设的须要性体现在以下几个方面：

　　The necessity of constructing a chronic disease follow-up management system is reflected in the following aspects:

　　提升慢病防治效果 ：慢病治理系统能够资助医护职员更有用地监控和治理患者的康健状态，，，，镌汰医疗肩负，，，，并提升慢病的防治效果。。。。。

　　Improving the effectiveness of chronic disease prevention and treatment: The chronic disease management system can help medical staff more effectively monitor and manage patients' health status, reduce medical burden, and enhance the effectiveness of chronic disease prevention and treatment.

　　个性化指导 ：系统基于数据剖析，，，，能够为患者提供个性化的慢病治理计划，，，，包括饮食、运动等生涯方法的指导，，，，以及药物治疗的建议，，，，从而提高治理效果。。。。。

　　Personalized guidance: Based on data analysis, the system can provide patients with personalized chronic disease management plans, including guidance on lifestyle such as diet and exercise, as well as medication treatment recommendations, thereby improving management effectiveness.

　　提高患者依从性 ：通过慢病随访系统，，，，医护职员可以催促患者坚持生涯方法改变和药物治疗，，，，增进患者对自身心血管危险因素的控制。。。。。

　　Improving patient compliance: Through the chronic disease follow-up system, medical staff can urge patients to adhere to lifestyle changes and medication treatment, promoting patients' control over their own cardiovascular risk factors.

　　支持医生事情 ：系统支持自动化随访流程，，，，减轻医生事情肩负，，，，提高事情效率，，，，并确保随访质量的稳固性。。。。。

　　Supporting doctors' work: The system supports automated follow-up processes, reducing the workload of doctors, improving work efficiency, and ensuring the stability of follow-up quality.

　　优化医疗资源设置 ：慢病治理系统整合了患者数据，，，，支持跨医疗机构的远程会诊，，，，突破了地区限制，，，，提高了医疗资源的使用效率。。。。。

　　Optimizing medical resource allocation: The chronic disease management system integrates patient data, supports remote consultations across medical institutions, breaks geographical limitations, and improves the efficiency of medical resource utilization.

　　推动医共体建设 ：系统支持细密型县域医共体建设，，，，通过数据共享和协同事情，，，，增进了急慢分治和上下联动的医疗效劳模式，，，，提高了慢病的知晓率和诊断率，，，，减轻了患者的经济肩负。。。。。

　　Promoting the construction of medical communities: The system supports the construction of closely knit county-level medical communities, and through data sharing and collaborative work, promotes the medical service model of emergency and chronic treatment and top-down linkage, improves the awareness and diagnosis rate of chronic diseases, and reduces the economic burden on patients.

　　综上所述，，，，慢病随访治理系统的建设关于提升慢病治理效率、优化医疗资源设置、提高患者知足度以及推动医疗效劳同质化等方面都具有十分主要的意义

　　In summary, the construction of a chronic disease follow-up management system is of great significance for improving the efficiency of chronic disease management, optimizing the allocation of medical resources, increasing patient satisfaction, and promoting the homogenization of medical services

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