股骨颈骨折实施临床路径前后效率效益分析

Efficiency and effectiveness analysis on femoral neck fracture before and after implementing clinical pathway

目的:评价股骨颈骨折病种临床路径实施的住院费用、医疗质量和效率。方法:采用历史同期对照,对93例路径实施前和91例实施后的股骨颈骨折入院患者相关指标进行对比分析。结果:股骨颈骨折的次均住院费用增加了9.25%;住院天数的中位数降低了2天;术前住院天数的中位数没有变化,四分位间距减少了4天。结论:在不影响医疗质量的前提下,股骨颈骨折路径的实施有效地缩短了住院天数,临床路径工作需要强有力的协调机制、更深入的工作基础和配套政策来保证执行效果。

Objectives： To evaluate the hospitalization expenses, medical quality and efficiency of femoral neck fracture with the implementation of clinical pathway. Methods： History case control methods were used to compare relative indictors. 93 cases of femoral neck fracture patients before implementing clinical pathway and 91 cases after implementing it were selected a the sample. Results： The hospitalization expenses of femoral neck fracture increased 9.25 percent, while the median of hospital stay length has decreased 2days, and the median of preoperative hospital days did not change, while the quartile has reduced 4 days. Conclusions： Under the preconditions of not affecting the quality of medical care, the femoral neck fracture clinical pathway effectively shorten the average length of stay. Clinical pathways work requires a strong coordination mechanism, further basis and supporting policies to ensure implementation of the effectiveness.