临床路径在新建医院医疗质量管理中的作用

The Effect of Clinical Pathway in Medical Quality of New Hospital

目的通过对社区获得性肺炎、自发性气胸、卵巢囊肿等3个病种进行临床路径管理,观察实施临床路径对新建医院医疗质量的影响。方法回顾性分析某新建医院住院的社区获得性肺炎、自发性气胸、卵巢囊肿患者临床资料,以2017年3月1日-2018年2月28日前未实施临床路径前病例为对照组,2018年3月1日-2019年2月28日实施临床路径后病例为观察组,观察分析实施临床路径对上述3种疾病诊断结果、病历质量、临床用药、住院时间以及医疗费用等影响。结果2组患者出入院诊断符合率均为100%,无统计学差异(P>0.05);观察组甲级病历率明显高于对照组,差异具有统计学意义(P<0.05);观察组次均开具医嘱耗时及医嘱修改次数均少于对照组,有统计学差异(均P<0.01);观察组平均住院天数、总住院费用、药品费用明显低于对照组,有显著统计学差异(P<0.01)。结论在新建医院实施临床路径能够规范医师诊疗行为,减少医嘱差错,降低患者住院天数及住院费用。

Objectives To study the effect of clinical pathway on the medical quality of new hospital through the clinical pathway management of patients with community acquired pneumonia,spontaneous pneumothorax and ovarian cyst.Methods A retrospective analysis of the patients with community acquired pneumonia,spontaneous pneumothorax or ovarian cyst from March 1,2017 to February 28,2019 in a new Hospital,which before February 28,2018 without the implementation of clinical pathway for the control group,and after the implementation of the clinical pathway for the observation group,to observation for disease diagnosis and medical record quality,clinical medicine,length of hospital stay and cost,etc.Results Two groups of patients diagnosis coincidence rate was 100%,no significant difference(P>0.05);the observation group of patients with grade A medical record rate was significantly higher than the control group,the difference was statistically significant(P<0.05);the observation group were prescribed time order modification times were less than the control group,there was significant difference the observation group(P<0.01);the average hospitalization days and total hospitalization expenses,drug costs significantly lower than the control group,with significant difference(P<0.01).Conclusions The implementation of clinical pathway in new hospital could regulate the behavior of doctors,reduce doctor’s error advice and expenses of patients in hospital.