以临床路径为契机实行主要住院指标考核

Implement the major hospital indexes examination using clinical pathway as an opportunity

目的 探索以实施临床路径为契机,实行主要住院指标考核的方法.方法 根据2008-2010年3年的基线资料,参考省（自治区）内同级医院的数据,设定基准值,制定考核标准,对临床科室实行平均住院日、次均住院费用、药品比例三项指标的考核,并采取分项奖励措施,根据较基准值下降的比率每月给予相应奖励.结果 全院和临床科室的平均住院日、次均住院费用、药品比例三项指标较上年同期均下降,且差异有统计学意义（内科系统：t=27.479、14.462、11.362,均P＜0.01；外科系统：t=18.944、16.029、12.071,均P＜0.01）.结论 实行主要住院指标考核,与实施临床路径相结合,可有效缩短平均住院日,降低次均住院费用和药品比例,减轻患者经济负担.

Objective To explore the method of the major hospital indexes examination using clinical pathway as an opportunity.Methods Based on the material of our hospital from 2008 to 2010,reference the data of the same level hospital in Xinjiang Uygur Autonomous Region,we set the benchmark and formulated the examination standard of three examination indexes：average length of stay （ALOS）,average hospitalization expense and drug proportion.Meanwhile,we took the subentry incentives to give the corresponding reward to clinical departments according to the decreases rate compared with the benchmark monthly.Results ALOS,average hospitalization expense and drug proportion of department and the whole hospital were obviously decreased compared with the same period last year,and the differences were statistically significant （Medical system：t =27.479,14.462,11.362,all P 〈 0.01 ; Surgical system：t =18.944,16.029,12.071,all P 〈 0.01）.Conclusion After using the examination methods and combining clinical pathway,the effects are obvious,which can effectively shorten ALOS,reduce average hospitalization expense and drug proportion,so as to relieve the patients＆#39; economic burden.