前列腺增生钬激光剜除术临床路径与单病种成本控制管理研究与实践

Practice and study in clinical pathway and cost control of holmium laser enucleation of the prostate for benign prostatic hyperplasia

目的通过对前列腺增生钬激光剜除术临床路径与单病种成本控制管理指标的分析,评价单病种临床路径和成本控制应用于临床管理的效果。方法收集整理2006年7月—2008年6月泌尿外科前列腺增生钬激光剜除术患者的信息,以其手术并发症发生率、平均住院天数、平均住院费用、患者满意率等作为评价指标,将实验组(应用单病种临床路径和医疗成本控制管理组)及对照组(未应用单病种临床路径和成本控制管理组)进行对比分析。结果应用病种临床路径和成本控制管理的患者与未应用这一方式的患者之间在手术并发症发生率、平均住院时间、平均住院费用、患者满意率方面有统计学显著差异。结论单病种临床路径和成本控制管理模式应用于前列腺增生钬激光剜除术,可以明显促进持续性质量改进(Continuous Quality Improvement,CQI)、缩短平均住院时间、降低住院费用、提高患者满意率。

Objective To evaluate the implementation effect of clinical pathway （CP） and cost control （CC） in benign prostatic hyperplasia patients undergoing holmium laser enucleation of the prostate. Methods After consulting the in-formation of the hospitalized patients after the surgery of holmium laser enucleation of the prostate from July 2006 to June 2008, we analyzed the effect of CP and CC using the average length of stay and the hospital charges for the patients as the evaluating indexes. Results There was significant difference in CQI,the average length of stay, the hospital charges for the patients, and patient satisfaction between the CP-CC groups and the traditional groups. Conclusion The method of clinical pathway and cost control can markedly improve medical quality and patient satisfaction, decrease the average length of stay and the hospital charges for the benign prostatic hyperplasia patients undergoing holmium laser enucleation of the prostate.