临床路径对单病种管理影响的Meta分析

Meta analysis for the effect of clinical pathways on single disease management

目的分析实施临床路径对单病种管理的影响。方法收集有关子宫肌瘤、胆道良性疾病和甲状腺肿瘤3种常见疾病实施临床路径治疗对单病种管理影响的临床对照研究，根据纳入标准，对纳入文献进行Meta分析，并对结果进行敏感性分析。结果纳入21篇文献，Meta分析结果显示，3种疾病临床路径组患者住院总费用（WMD=-1046．06，95％CI：-1281．15～-810．96，P〈0．00001）和住院天数（WMD=-2．18，95％CI：-2．59～-1．76，P〈0．00001）均低于非临床路径组，两者差异均有统计学意义。结论实施临床路径可以进一步降低单病种疾病的住院费用，缩短住院天数。

Objective To analyze the effect of clinical pathways on single disease management. Methods Clinical controlled trials on tumors of uterine, benign biliary tract diseases and benign thyroid neoplasm were collected and related literatures were screened according to the criteria of inclusion. The literature so collected underwent a Meta analysis. Results A total of 21 literatures were included. Meta analysis indicated that statistical difference existed in the total cost of hospitalization（WMD=- 1046. 06, 95%CI： -- 1281.15 -- 810. 96, P〈 0. 00001） and length of hospital stay（WMD=- 2. 18, 95%CI： --2. 59-- 1.76, P〈0. 00001）between non-clinical pathways group and clinical pathways group. Conclusion Implementation of clinical pathways can further reduce hospital costs and shorten hospital days of the single disease management.