城镇基本医疗保险参保人员住院临床路径分析

Analysis on the Clinical Pathway Use of Urban Basic Medical Insurance Inpatients

目前临床路径管理的病种范围较窄,其人数和费用仅分别约占总量1/5和1/4;住院病人实际治疗措施和标准临床路径存在着较大的差异,尤其是检查检验项目和抗菌药物的使用,存在着较严重的过度使用和滥用;不同类型地区、城市、医疗机构之间实际临床治疗与临床路径符合度差异较大。建议逐步扩大临床路径管理的病种范围,并注重临床路径的实施效果评价。

The scope of diseases managed by clinical pathways was narrow, the inpatients and expenses of which only occupied 1/5 and 1/4 of the total. There was great disparity between the actual use of diagnostic and therapeutic measures and the standardized clinical pathways, especially the use of laboratory examination and antibiotic drugs. The accordance to standard clinical pathways was also disparity between different areas, cities and hospitals. It recommends that the scope of diseases managed by clinical pathways should be expanded gradually and the effect of the clinical pathway implementation should be evaluated opportunely.