临床路径变异因素的原因探讨

Reason Exploration of the Variation of Clinical Pathways

目的了解临床路径的有效使用现状,充分发现临床路径在医疗上的功能。方法收集某省级三甲医院,2008年-2013年6个病种共计6943个病例,随机分为对照组和CP组,运用统计分析软件SPSS 16.0处理,数据采用中位数来表达,CP组与对照组用Mann-Whitney Test检验,P<0.05为有统计学意义。结果临床路径的实施效果对于缩短平均住院日有较明显的效果,部分费用有所下降,其中膝关节置换,该病种的平均住院总费用,CP组与对照组的比较,减少最明显,从70855元减少到61397元,平均费用下降13.35%。结论临床路径的推广对提高医疗质量、降低治疗费用和规范医疗流程有显著效果。

Objectives To acquire the current effective utilization situation of clinical pathways. and fully discover the medical treatment function of them. Methods 6943 cases of 6 diseases entities were selected in a provincial Tertiary and Class A Hospital from 2008 to 2013. then divided into control group and CP group randomly.the data was expressed by median with the application of statistical analysis software SPSS 16.0. Mann-Whitney Test method was adopted between the two groups and it was of statistical significance with P〈0.05. Results The application of clinical pathways had obviously effect in the decreasing of average hospitalization days. some expenses also decreased. in which the average hospitalization expense of patients who accepted knee prosthesis decreased from 70855 to 61397. decreased for 13.35%. which decreased mostly in the two groups. Conclusions The promotion of clinical pathways had significant effect to the improvement of medical treatment quality as well as the decreasing of therapeutic expenses and the standardization of medical treatment process.