临床路径在计划性剖宫产中的应用

Application of Clinical Pathway in Scheduled Caesarean Section

目的:探讨卫生部试行的临床路径管理在我院计划性剖宫产中的应用效果。方法:选取185例已实施临床路径管理的计划性剖宫产孕妇(路径组)和96例未实施临床路径管理的计划性剖宫产孕妇(对照组),对两组孕妇的住院天数、各种住院费用、各项指标的变异系数和构成比,以及患者的满意度和术后并发症等指标进行综合比较分析。结果:路径组住院天数比对照组缩短,差异有高度统计学意义(P=0.00),但住院总费用两组比较,差异无统计学意义(P=0.19);对于住院总费用的构成变化,路径组药费下降,但治疗费增加,两组间的药费和治疗费比较,差异均有统计学意义(P<0.05);路径组变异系数波动总体较对照组小,患者满意度有所提高,但术后并发症率无明显改变。结论:临床路径应用于我院计划性剖宫产起到了规范医疗行为的作用。

Objective：To evaluate the effect of clinical pathway tried out by the Ministry of Public Health in the scheduled caesarean section.Methods：185 cases with scheduled caesarean section were selected clinical pathway （Pathway group）. 96 cases were selected non clinical pathway as control group. The time of hospitalization, various medical care costs, coefficient of variation and constituent ratio of different parameters, and patient’s satisfaction degree as well as their complications after operation were analyzed and compared between the two groups. Results：The time of hospitalization in pathway group was shorter than that in control group. There was statistical difference between them（P=0.00）. There was no statistical difference between them about medical care costs（P=0.19）. In pathway group, the constituent ratio of medical care cost was changed. The drug costs were decreased, but the treatment costs were increased. There was statistical difference among two groups about drug and treatment costs（P0.05）. Compared to control group, the coefficient of variation in pathway group was smaller than control group, and the patient’s satisfactory degree was increased, but there was no obvious changes about complications after operation.Conclusions：Clinical pathway applied in our hospital standardizes medical treatment in the scheduled caesarean section.