武汉市某三甲医院IgA肾病肾穿刺活检患者临床路径实施效果评价

Effect of Clinical Pathway with IgA Nephropathy after Renal Biopsy in a Grade A Hospital in Wuhan

目的:评价武汉市某三甲医院IgA肾病患者实施临床路径管理后的效果。方法:选取2010-2013年共415例患者的住院数据,采用历史对照法分析临床路径实施前后年均住院次数、年均住院天数、年均住院费用以及治疗效果等指标。结果:实施临床路径后,患者年均住院次数及年均住院天数均出现明显下降,年均住院费用出现下降,但差异不具有显著性(P>0.05);费用结构上,患者的药费、诊疗费以及其他费用出现不同程度下降,差异均不具有统计学意义(P>0.05);化验费和检查费出现不同程度增加,其中检查费增加具有统计学意义(P<0.05);实验组患者各项检查生化指标较对照组均有小幅度改善,但差异均不具有统计学意义(P>0.05)。结论:该院IgA肾病肾穿刺活检患者实施临床路径能减少年均住院次数,缩短年均住院天数,有助于降低年均住院费用。但临床路径实施对降低患者检查费、化验费以及提高疗效的结论还有待于相关研究进一步探讨。

Objective： This study evaluates the effect of entering clinical pathway of patients with IgA osteopathy after renal biopsy to provide the relevant reference. Methods： Analyzing 415 patients with IgA nephropathy during 2010 -2013, using historical comparison to explain times, days, costs as well as treatment effect before and after entering the clinical pathway. Results： After entering clinical pathway, times, and days in hospital have declined dramatically. Although the costs have descended, there is no difference between the data before（ P 〉 0.05 ）. According to statistical analysis, the medical costs, treatment costs and other costs have declined, but it makes little statistical significance （ P 〉 0. 05 ）. The la- boratory costs and checking costs increased, and only checking cost plays an important role in the data comparison（ P 〈 0.05 ）. All the biochemi- cal indicator declined a little, but it doesnt make sense（ P 〉 0.05 ）. Conclusion ：Times, days and costs have declined apparently among patients with IgA nephropathy after renal biopsy who havent entered the clinical pathway. But we need more data to testify whether laboratory or checking costs have declined, whether treatment effect would have been better after entering clinical nathwav.