实施临床路径管理毛细支气管炎的效果分析

The effect analysis of clinical pathway management for capillary bronchitis

目的：分析儿科实施毛细支气管炎临床路径管理的临床效果。方法选取实施临床路径管理后的毛细支气管炎的患儿75例为观察组，选择实施临床路径管理前在该院住院治疗的毛细支气管炎患儿68例为对照组，对比分析两组的住院费用、平均住院日、抗菌药物使用率、治愈率、医院感染率、2周内再住院率、服务满意度等综合指标。结果观察组药品总费用（1198．49±397．48）元，低于对照组的（1324．05±376．57）元（Z ＝2．00，P ＜0．05）；观察组平均住院日（6．99±2．39）d，短于对照组的（8．01±2．22）d（Z ＝2．62， P ＜0．05）；观察组服务满意度（95％）高于对照组（82％）（χ^2＝5．44，P ＜0．05）；观察组抗菌药物使用率（49％）显著低于对照组（95％）（χ^2＝27．59，P ＜0．01）。两组治愈率（医嘱离院率）、医院感染率、2周内再住院率差异均无统计学意义（均 P ＞0．05）。结论基层医院儿科对毛细支气炎病种实行路径管理，在保证医疗质量的前提下可规范医疗行为、减少平均住院日、控制医疗成本，提高了服务满意度。

Objective To analyze the effect of clinical pathway management for capillary bronchitis in Department of Pediatrics.Methods 75 children with capillary bronchitis after the implementation of clinical pathway management were selected as the observation group,and 68 children with capillary bronchitis before the implementa-tion of clinical pathway management were selected as the control group.The hospitalization cost,average hospital stay, antibiotic use rate,cure rate,nonsocomial infection rate,rehospitalization rate within two weeks,service satisfaction and other comprehensive indices were compared.Result The total cost of drug of the observation group[（1 198.49 ± 397.48）yuan]was lower than （1 324.05 ±376.57）yuan of the control group（Z =2.00,P 〈0.05）.The average hospital stay of the observation group[（6.99 ±2.39）d]was shorter than （8.01 ±2.22）d of the control group（Z =2.62,P 〈0.05）.The service satisfaction rate of the observation group（95%）was higher than 82% of the control group（χ^2 =5.44,P 〈0.05）.The antimicrobial use rate of the observation group（49%）was apparently lower than 95% of the control group （χ^2 =27.59,P 〈0.01）.There were no statistically significant differences between the two groups in cure rate（hospital discharge rate）,nosocomial infection rate and rehospitalization rate within two weeks（all P 〉0.05）.Conclusion Clinical pathway management for capillary bronchitis in Department of Pediatrics of primary hospital can play a role in standardizing medical practice,reducing average hospitalization days,controlling medical cost,and improving service satisfaction under the precondition of ensuring medical quality.