电子病历系统对临床路径管理的影响研究

Impact of Electronic Medical Record System on Clinical Pathway Management

目的探讨电子病历系统对临床路径管理的影响。方法入选河北北方学院附属第一医院2014年1月—2014年6月进入临床路径管理的512例患者(包括胆囊结石腹腔镜胆囊切除术、慢性鼻-鼻窦炎、2型糖尿病3个病种)作为观察对象,其中258例患者采用电子病历系统进行临床路径管理,254例患者采用纸质病历系统进行临床路径管理,比较两组病历质量、路径变异率、病种治疗费用及患者满意度。结果观察组甲级率明显高于对照组、乙级率明显低于对照组,差异均具有统计学意义(均P<0.05);观察组路径变异率为7.8%(20/258),显著低于对照组15.0%(38/254),差异有统计学意义(P<0.05);观察组3个病种的治疗费用均显著低于对照组,差异均有统计学意义(均P<0.05);观察组患者满意度为95.3%(246/258),显著高于对照组的77.2%(196/254),差异有统计学意义(P<0.05)。结论电子病历系统与临床路径管理结合有助于降低路径变异率,提高医护人员工作效率,降低医疗费用,提高患者满意度。

Objective To investigate the effect of electronic medical record system in Clinical Pathway management. Mhods 512 cases of Clinical Pathway management （3 diseases including gallstone patients with laparoscopic cholecystectomy, chronic rhinosinusitis and type 2 diabetes） from January, 2014 to June, 2014 in The First Affiliated Hospital of Hebei North University were regarded as the observation objects. Among them, 258 cases were carried on Clinical Pathway management with electronic medical records system. 254 patients were treated by medical record system Clinical Pathway management, through comparing medical quality and path mutation rate, disease treatment costs and patient satisfaction of two groups. Results The medical rate of grade A in observation group was significantly higher than control group, and grade B was significantly lower than control group. The differences were statistically significant （P〈0.05）. The pathway mutation rate in observation group was 7.8% （20/258）, which was significantly lower than 15.0% （38/254） in control group. The difference was statistically significant （P〈0.05）; 3 diseases treatment costs in observation group were significantly lower than those in control group. The differences were statistically significant （P〈0.05）. Patient satisfaction in observation group was 95.3% （246/258）, which significantly higher than 77.2% （196/ 254） in control group. The difference was statistically significant （P〈0.05）. Conclusion The electronic medical record system and Clinical Pathway management helps to reduce the path mutation rate, improve the work efficiency of medical staff, reduce the medical cost and improve patient satisfaction.