临床路径在足月胎膜早破行阴道分娩中的应用

Application of Clinical Pathway in Vaginal Delivery Due to Mature Premature Rupture of Membranes

目的探讨临床路径在足月胎膜早破行阴道分娩中的应用效果。方法通过非同期队列研究,对实施与未实施临床路径的足月胎膜早破行阴道分娩患者的住院天数、住院总费用、各种住院费用、患者满意度以及各项指标变异系数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〔(3.2±0.6)vs(3.3±0.6)天〕、住院总费用〔(2817.4±146.2)vs(2838.7±194.0)元〕低,与对照组比较,差异均无统计学意义(P>0.05)。对于住院费用各项比较,路径组药费下降〔(484.4±40.7)vs(511.0±59.2)元〕,但治疗费增加〔(445.1±52.4)vs(420.8±50.1)元〕,两组间的药费和治疗费比较,差异均有统计学意义(P<0.05)。路径组变异系数比对照组小,患者满意度有所提高。结论实施临床路径后,患者药费下降、满意度提高,临床路径应用于我院足月胎膜早破行阴道分娩起到了规范医疗行为的作用。

Objective To investigate the application effect of clinical pathway in vaginal delivery due to mature premature rupture of membranes. Methods Through the asynchronous cohort studies, the hospitalization days of patients with vaginal delivery due to mature premature rupture of membranes who were treated and not treated by clinical pathway, the indicators, including total hospitalization expenses, all kinds of hospitalization expenses, satisfaction and the coefficient of variation of each indicator, etc. were comprehensive comparative analyzed. Results Compared with control group, hospitalization days of pathway group were shorter [ （3.2 ± 0.6） vs（3.3 ± 0.6） d] and the total hospitalization expenses was lower[ （2817.4 ± 146.2） vs （2838.7 ± 194.0） yuan~, there was no significant difference （P 〉 0.05）. For each hospitalization expenses, pathway group spent less expenses for medicine[ （484.4 ± 40. 7） vs（511.0 ± 59.2） yuan~, but more expenses for treatment[ （445.1 ± 52.4） vs（420.8 ± 50.1） yuanJ, to compare the expenses for medicine and treatment between the two groups respectively, there were significant differences （ P 〈 0.05）. Compared with control group, in pathway group, the coefficient of variation was smaller and the patient satisfaction increased. Conclusions After treated by clinical pathway, expenses for medicine decreased, patients satisfaction increased, and the application of clinical pathway in vaginal delivery due to mature premature rupture of membranes in our hospital played an important role in regulating medical behavior.