肺癌手术病人临床路径管理效果评价

Evaluation on Efficacy of Clinical Pathways Management on Patients with Lung Cancer Surgeries

目的评价云南省第一人民医院胸外科对肺癌手术病人进行临床路径管理的效果,为主管部门控制肺癌医疗费用提供依据。方法调查胸外科2002年1月至2009年9月期间收治的肺癌手术病人的住院信息、住院总费用等,对比肺癌手术病人临床路径管理前后的差异,从而评价临床路径管理对肺癌手术病人管理的意义。结果经过对比分析,研究组的住院总天数显著少于对照组(t=11.768,P<0.01);术前住院日显著少于对照组((t=4.391,P<0.01);住院总费用显著低于对照组((t=2.292,P<0.05);多项分项费用低于对照组(P<0.01或P<0.05)。均具有统计学意义。结论胸外科对肺癌手术病人使用临床路径管理缩短了病人住院总天数、术前的住院日,降低了住院总费用,为来院就诊的肺癌手术病人减轻了负担,对控制肺癌手术病人的医疗费用具有一定的意义。

Objective To evaluate the efficacy of clinical pathways management on patients with lung cancer surgeries in thoracic surgery department of the First People’s Hospital of Yunnan Province in order to provide evidence for competent authorities to control the medical cost of lung cancer.Methods The hospitalization information and hospitalization costs of patients receiving lung cancer surgeries admitted in thoracic surgery department from Jan.2002 to Sep.2009 were investigated,and differences before and after clinical pathways management were compared to evaluate the impacts on patients by management.Results The comparison showed that the experimental group had less total hospitalization days（t=11.768,P〈0.01）,shorter preparation days before surgeries（t=4.391,P〈0.01）,lower total costs（t=2.292,P〈0.05） and various concrete fees（P〈0.01 or P〈0.05） than controls,with statistical significance.Conclusion The application of clinical pathways management to patients with lung cancer surgeries shortens the total hospitalization days and preparation days before surgery,reduces the total costs,really relieving the economic burden of patients,which can be used to control the medical costs of patients.