新疆某大型综合性三级甲等医院临床路径管理的效果评价

Evaluation on effect of clinical pathway management in a grade-A class-three comprehensive hospital of Xinjiang Uygur Autonomous Region

目的分析临床路径的实施对促进医院科室运行效率提升的效果。方法选取新疆某三甲医院收治率较高的原发性高血压病、老年性白内障、腰椎间盘突出症和子宫平滑肌瘤4个病种,将采用临床路径进行规范的1323份病例作为试验组,根据相关疾病诊疗规范、诊疗指南及医师诊疗经验等进行常规诊疗,采用常规路径进行医、护、技等标准协作的765份病例作为对照组。采用SPSS 22.0软件进行统计学分析。结果除子宫平滑肌瘤在性别构成上不具有可比性外,试验组和对照组其余病例资料在性别构成及年龄分布上,差异无统计学意义;试验组和对照组4个病种在治疗效果上比较,差异无统计学意义;试验组的住院天数比对照组的住院天数短,差异有统计学意义(P<0.05)。除子宫平滑肌瘤的平均住院费用以外,试验组为27 625.47元,对照组为33 257.81元,差异无统计学意义;试验组和对照组其他3个病种的总费用均显著下降,差异有统计学意义(P<0.05)。结论临床路径的实施在核心治疗方案不变的情况下可以减少平均住院天数,减轻患者的住院经济负担。

Objective To analyze the effect of implementation of clinical pathways for hospital departments to promote the enhancement of operational efficiency. Methods The four diseases, primary hypertension, cataract, lumbar disc disease and uterine fibroids in a grade-A class-three hospital of Xinjiang with higher inpatient rates were selected; 1323 cases applied with clinical pathways were chosen as the experimental group, 765 cases applied conventional pathways were chosen as the control group. SPSS 22.0 was used for the statistical analysis. Results Except uterine leiomyoma was not comparable in gender, there were no significant differences in gender composition and age distribution among other cases between the experimental group and the control group; 4 diseases were compared in the treatment effect, there was no significant difference between the experimental group and the control group. The length of hospital stay in the experimental group was shorter than that of the control group, and the difference was statistically significant（P〈0.05）. Except uterine leiomyoma, the average hospitalization cost of the experimental group was 27 625.47 yuan, and that of the control group was 33 257.81 yuan, there was no significant difference; the total cost of the other 3 diseases were all significantly decreased, and the differences were statistically significant between the experimental group and the control group（P〈0.05）. Conclusions Implementation of clinical pathways can reduce the average length of stay, reduce the burden of hospitalized patients when core therapeutic method is unchanged.