临床路径对3种常见精神疾病出院统计指标的影响

Effects of clinical pathway on 3 common discharge statistical indexes of patients with psychiatric disorders

目的:探讨实施临床路径对精神科住院患者常见病多发病临床统计指标的影响,观察临床路径在住院精神疾病治疗工作中的作用。方法:选取我院2015年7月1日到2016年9月30日住院患者中精神分裂症、抑郁障碍、双向情感障碍3种常见病,剔除不符合纳入临床路径管理条件者后,根据是否纳入临床路径管理分为临床路径组与对照组,分别统计其住院日数、治疗有效率、并发症发生率、死亡率、院内感染发生率、30日再住院率、住院费用、出院患者满意度等指标并进行比较。结果:临床路径组精神分裂症、抑郁障碍、双向情感障碍患者的平均住院日、住院费用与对照组比较差异有统计学意义(P<0.05),其它统计指标两组间比较差异无统计学意义。结论:对于精神分裂症、抑郁障碍、双向情感障碍实施临床路径管理有助于缩短平均住院日,减低住院费用,但是对于治疗有效率、30日再住院率、并发症发生率、死亡率、院内感染发生率、患者满意度无明显影响。

Objective： To explore effects of clinical pathway on statistical indexes of common diseases in psychiatric inpa- tients, and to observe the effects of clinical pathway in the treatment of psychiatric diseases. Methods： The inpatients with schizophre- nia, depression, and bipolar disorders in our hospital from July 1,2015 to September 30, 2016 were selected and divided into clinical pathway group and control group according to that whether the clinical pathway management conditions were met or not. The average days of hospitalization, the treatment efficiency, the incidence of complications, mortality, the incidence of infection in hospital, the 30 day readmission rate, hospitalization expenses, patients＂ satisfaction of the two groups were statistically analyzed and compared. Re- suits： There were significant differences in the average days of hospitalization and hospitalization expenses between the two groups （ P 〈0.05, P〈0.01 ） ; however, the differences of other indexes were not statistically significant. Conclusions： For the patient with schiz- ophrenia, depression, and bipolar disorders, the implementation of clinical pathway management could help to shorten the average hos- pitalization days and reduce the hospitalization costs, but has no obvious influence on the treatment efficiency, the 30 day readmission rate, complication rate, mortality and the incidence of infection in hospital, and patient satisfaction.