自然分娩临床路径的应用效果

The Application Effect of the Clinical Pathway of Natural Childbirth

目的研究自然分娩临床路径的应用情况,针对具体情况提出合理化改进措施。方法采用1:1病例对照研究方法,选取2012年1月-2015年12月期间纳入自然临产阴道分娩临床路径的产妇为临床路径组,对照严格按年龄、民族、职业、孕次、孕周、新生儿体重、付费方式进行匹配。运用SPSS17.0对两组平均住院日、费用情况以及产妇满意率进行统计分析。结果病例对照共55对,两组研究对象在匹配变量年龄、孕周、新生儿体重差异无统计学意义(P>0.05),具有可比性。实施临床路径后,临床路径组的住院天数由4.07天下降到2.11天,住院总费用由2162.44元下降到1728.76元,两组在住院天数和住院总费用方面比较有统计学意义(P<0.05)。临床路径组产妇对检查预约时间、治疗与病情的知情、治疗决定的知情和此次治疗4个方面的满意率高于对照组的满意率,差异具有统计学意义(P<0.05)。结论产科实施临床路径后,平均住院日下降,住院费用也得到有效的控制,提高产妇满意率的同时增进了医患沟通。但在临床路径告知方面还有所欠缺,需要改进。

Objectives To analyze the application situation of natural childbirth in our hospital,and put forward concrete conditions for specific conditions of our hospital. Methods 1：1 case-control study method was adopted in this study,the lying-in woman who were incorporated natural childbirth clinical pathway of our hospital were selected in January 2012 to December 2015 as the clinical pathway group,the control group was matched with clinical pathway group in age,nation,job,gravidity,payment system,gestational age,neonatal weight and payment system. SPSS17.0 was adopted to make an statistical analysis between the two groups in aspects such as average hospitalization days,the total expense in hospital and maternal satisfaction rate. Results The total number of clinical pathway group and control group is 55 pairs,the difference of age,gestational age and neonatal weight between clinical pathway group and control group were not significant（P〉0.05）,with comparability. After the introduction of clinical pathway,the average hospitalization days and the total expense in hospital in clinical pathway group were significantly lower than the control group. The average hospitalization days and the total expense in hospital had statistically significant differences between the two groups （P〈0.05）.maternal satisfaction rate of clinical pathway group to treatment was higher than control group,the difference is statistically significant （P〈0.05）. Conclusions After the introduction of clinical pathway,the average hospitalization days had decreased,the total expense in hospital had been controlled reasonably,and also enhanced maternal satisfaction rate and improved doctor-patient communication. But there were still shortages existing in the acquaintance of clinical pathway which needed to be improved.