临床路径管理对结核病医疗质量管理与控制的影响及对策

Influence of Clinical Pathway Management on Medical Quality Management and Control of Tuberculosis and Its Countermeasures

目的:评价临床路径管理对结核病诊疗质量管理与控制的影响及对策。方法:抽取2013年1月—2015年12月间结核科实施临床路径管理前诊治的肺结核患者病例资料为管理前组,另抽取2016年1月—2018年12月间结核科实施临床路径管理后诊治的肺结核患者病例资料为管理后组,汇总和分析管理前后两组资料中医疗质量(菌阴初治肺结核、菌阳初治肺结核、复治肺结核和结核性胸膜炎)控制率以及患者平均住院天数、住院次总费用、药占比及患者对治疗的满意度等相关指标的变化情况。结果:实施临床路径管理后,医院结核病医疗质量得到显著提高,住院天数由管理前的27.89d降至2018年的17.29d,住院费用及药占比均显著下降,患者对治疗的满意度也有所提高。结论:通过实施临床路径管理,规范了医务人员的诊疗行为,服务质量的满意度不断提升,促进医疗服务管理的规范化、精细化、信息化。

Objective:To evaluate the influence of clinical pathway management on medical quality management and control of tuberculosis and its countermeasures.Methods:The data of pulmonary tuberculosis patients diagnosed and treated before clinical pathway management in tuberculosis department from January 2013 to December 2015 were selected as the pre-management group.In addition,the data of pulmonary tuberculosis patients diagnosed and treated after clinical pathway management in tuberculosis department from January 2016 to December 2018 were selected as the post-management group.The control rate of medical quality (bacterial negative primary pulmonary tuberculosis,bacterial positive primary pulmonary tuberculosis,retreated pulmonary tuberculosis and tuberculosis pleurisy) in the two groups before and after management,and the changes of the average hospitalization days,the total cost of hospitalization, the proportion of drugs and the satisfaction of patients with treatment were summarized and analized.Results:After the implementation of clinical pathway management,the medical quality of tuberculosis in hospital has been significantly improved,and the number of hospitalization days decreased from 27.89 days before management to 17.29 days in 2018,the hospitalization expenses and the proportion of drugs decreased significantly,and patients' satisfaction with treatment was also improved.Conclusion:Through the implementation of clinical pathway management,which standardizes the diagnosis and treatment behavior of medical staff,and satisfaction with quality of service continues to improve, promoting the standardization,refinement and informatization of medical service management.