临床路径管理在外科手术中的实施效果观察

Evaluation of effect of clinical pathway management on surgical outcomes

目的观察临床路径管理在外科手术中的实施效果。方法随机抽取2014-09~2016-09的5个外科病种,其中实施临床路径管理的358例(计划性剖宫产92例、输尿管结石71例、子宫平滑肌瘤64例、腹股沟疝53例、急性阑尾炎78例)为观察组,未实施临床路径管理的217例(计划性剖宫产56例、输尿管结石43例、子宫平滑肌瘤39例、腹股沟疝32例、急性阑尾炎47例)为对照组,对各病种两组病例的次均住院费用、次均药品住院费用、平均住院日、患者满意度进行观察比较。结果两组比较显示,次均住院费用急性阑尾炎差异不大,其余4个病种差异有统计学意义(P<0.05);次均药品费用急性阑尾炎差异不大,其余4个病种差异有统计学意义(P<0.05);平均住院日5个病种观察组均低于对照组,差异有统计学意义(P<0.05);患者满意度腹股沟疝差异不大,其余4个病种差异有统计学意义(P<0.05)。结论临床路径管理不仅能降低次均费用和次均药物费用,而且还能缩短平均住院日以及提升患者满意度。

Objective To investigate the effect of clinical pathway management on surgical outcomes. Methods A total of 358 patients who were implemented clinical pathway management including 92 cases of planned cesarean section,71 cases of ureteral calculus,64 cases of uterine leiomyoma,53 cases of inguinal hernia and 78 cases of acute appendicitis were randomly collected as the observation group in our hospital from September 2014 to September2016.Other 217 patients who were not implemented clinical path management including 56 cases of planned cesarean section,43 cases of ureteral calculus,39 cases of uterine leiomyoma,32 cases of inguinal hernia and 47 cases of acute appendicitis were randomly collected as the control group.The average medical costs,drug costs,average hospitalization days and the patients＇satisfaction were compared between the clinical pathway group and non-clinical pathway group for the same diseases.ResultsThere were significant differences in the average medical costs and drug costs of planned cesarean section,ureteral calculus,leiomyoma of uterus and inguinal hernia disease between the clinical pathway and non-clinical pathway groups（P〈0.05）.There were significant differences in the average hospitalization days of the five diseases between the clinical pathway and non-clinical pathway groups（P〈0.05）.There were significant differences in the patients＇satisfactions of planned cesarean section,ureteral calculus,leiomyoma of uterus and acute appendicitis between the clinical pathway and non-clinical pathway groups（P〈0.05）.Conclusion Clinical pathway management can not only significantly reduce the average medical costs,drug costs and average hospitalization days but also significantly improve the patients＇satisfaction.