临床路径对住院天数和住院费用的影响分析

Impact Analysis of Clinical Pathways to the Hospitalization Days and Expenses

目的评价耳鼻咽喉科两个病种临床路径实施效果,探讨临床路径对住院天数和住院费用的影响。方法采用历史对照组方法,对慢性鼻窦炎和慢性化脓性中耳炎临床路径开展前后,患者的住院天数和住院费用等指标变化进行综合评价。结果临床路径实施后,慢性化脓性中耳炎次均住院日、次均住院费用、次均药费、次均检查费和手术费下降,P<0.001,差异均有统计学意义;慢性鼻窦炎次均住院费用差异无统计学意义,但次均住院日、次均药费显著下降,P<0.001;两个病种材料费均显著增加,P<0.001。结论临床路径实施可以有效缩短患者住院天数,但对住院费用影响没有住院天数显著,只在一定程度上控制了住院费用的增长。

Objectives To evaluate the implementation effects of the clinical pathways of two kinds of diseases in otolaryngology department,and investigate its impact to hospitalization days and expenses.Methods With the application of historical control group research methods,to conduct a comprehensive evaluation on the variation of indexes included hospitalization days,hospitalization costs and so on before and after the implementation of the clinical pathways of chronic sinusitis and chronic suppurative otitis media.Results After the implementation of clinical pathways,the indexes of chronic suppurative otitis media patients included average hospitalization days,hospitalization costs,medicine expenses,examination expenses and operation costs had decreased,the difference was of statistical significance（P＜0.001）.The relevant indexes of chronic sinusitis patients were also decreased obviously included average hospitalization days and medicine expenses（P＜ 0.001）,while the difference of average hospitalization expenses had no statistical significance.The materials expenses of both the two entities were increased significantly（P＜0.001）.Conclusions The implementation of clinical pathways could effectively shorten the average hospitalization days and control the growth of hospitalization costs in a certain extent while the impact to hospitalization expenses was not significant than hospitalization days.