Chronic diseases management is critical in prevention of severe complications of chronic diseases and control of chronic diseases. So far how to improve the quality and effectiveness of the management is an important problem to be resolved in chronic diseases management practice. In this paper, three management modes from the angle of evidence-based medicine were introduced based on the analysis of epidemiological characteristics and requirements of prevention and treatment of chronic diseases in our country. Furthermore,the concepts and practices of chronic diseases management-based on the evidence-based medicine were proposed in order to provide a reference for the basical health service providers such as general practitioners and to further improve the service quality and control of service cost.%慢性病管理是预防严重慢性病并发症发生、有效防控慢性病的关键.如何提高管理的质量与效益是目前慢性病管理实践中亟需解决的重要问题.文章在分析我国慢性病流行特征与防治需求的基础上,从循证医学角度,介绍了3种慢性病管理模式,提出了基于循证医学的慢性病管理的概念和做法,旨在为全科医生等基本医疗卫生服务提供者提供借鉴,进一步改善服务质量并控制服务成本.
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