社区获得性肺炎临床路径医疗费用分析

Medical Expenses Analysis on the Clinical Pathways of Community Acquired Pneumonia

目的通过对住院儿童社区获得性肺炎(CAP)单病种管理临床路径实施情况分析,评价临床路径对出院患儿费用的影响。方法选择2013年7月1日-2013年12月31日出院患儿符合CAP的患者247例作为非路径组,同期收治符合CAP的患者241例作为路径组,将两组进行比较分析。结果路径组患儿的住院时间较非路径组缩短0.856天(P<0.05),差异有统计学意义;住院费用较非路径组减少669元(P<0.05),差异有统计学意义。路径组患儿住院费用的减少主要包括床位费、护理费、化验费、诊疗费和药品费的减少。结论临床路径管理在儿童CAP单病种管理的应用,可缩短患儿住院天数,住院总费用及各项具体费用均得到明显的控制,使得患儿住院诊疗措施合理化,减少诊疗过程中的随意性和过度医疗的发生。

Objectives To evaluate the clinical pathway influence discharged children medical expenses through analyzing the implementation of children＇s community acquired pneumonia single disease management clinical pathway. Methods 488 inpatients with children＇s community acquired pneumonia were classified into non-clinical pathway group（n=247） and clinical pathway group（n=241） from Jiangxi Provincial Children＇s Hospital from 1st July to 31 st December 2013. The data were compared and analyzed. Results The length of hospital day was 0.856 days shorten in the clinical pathway group than in the non-clinical pathway group, and the average total costs in the clinical pathway group decrease 669 yuan（P〈0.05）. The total costs decline main including bed charges, care free, medical costs and pharmaceutical costs. Conclusions The implementation of clinical pathway management in the children＇s community acquired pneumonia could be shorten the length of hospital stay and decrease the total costs and cost of each item. It could regulate the medical care activities and decrease the arbitrary and excessive medications in clinical practice.