临床路径在社区获得性肺炎治疗中的作用

Effects of clinical pathway on medicine fee drug proportion in adult community-acquired pneumonia

目的评价通过实施临床路径管理社区获得性肺炎（community acquired pneumonia,CAP）对药占比的影响。方法分析2011年3月至2012年3月煤炭总医院呼吸科收治的131例CAP患者，随机分为临床路径组（70例，其中65例完成路径）和对照组（61例），临床路径组实施临床路径管理，对照组实施非临床路径管理，观察两组在住院总费用、住院药费、住院药费占住院总费用的比例（药占比）、住院天数、临床疗效方面的情况。结果临床路径组在住院总花费、住院药费、药占比、住院天数方面较对照组均显著下降，差异有统计学意义（P〈0．05），两组的临床疗效比较，临床路径组治疗有效率高于对照组，差异有统计学意义（P〈0．05）。结论实施临床路径能够缩短住院天数，有效节省住院总花费、住院药费、降低药占比，提高临床疗效。

Objective To investigate the effects of clinical pathway on medicine fee drug proportion in adult commun~,ty-acquired pneumonia. Methods One hundred and thirty-one adults inpatients with community-acquired pneumonia were recruited in our department and then randomly classified into clinical pathway management group （70 cases, 65 cases finished） and non-clinical pathway management group （61 cases）. The total hospital expenses, medicine fee, drug proportion, the length of stay, and clinical efficacy were compared between two groups. Results The length of stay, total hospital expenses, medicine fee and drug proportion were decreased in clinical pathway management group, compared with non-clinical pathway management group （ P 〈0.05）. Difference was found in clinical efficacy between two groups （ P 〈0.05）. Conclusions The clinical pathway contributes to the reduction of the length of stay, total hospital expenses and drug proportion.