基于平行轨道设计对小儿支气管肺炎合并轮状病毒性肠炎临床路径效果分析

Parallel-track design of clinical pathway for pediatric bronchopneumonia with rotavirus enteritis

目的探讨使用平行轨道路径电子模板对小儿支气管肺炎合并轮状病毒性肠炎住院病例进行临床路径管理的可行性与应用价值。方法选取2017年9月至2018年10月于儿科住院治疗的小儿支气管肺炎合并轮状病毒性肠炎患者共206例,随机分为对照组(103例)和观察组(103例),对照组采用传统临床路径方法,观察组采用平行轨道设计的临床路径,比较两组患者入径率、完成率、住院费用以及住院时间等指标。结果观察组临床路径进入率高达92.23%,显著高于对照组的65.04%,差异具有统计学意义(P<0.01);同时观察组路径完成率(78.64%)显著高于对照组(27.18%),差异具有统计学意义(P<0.01)。观察组日均治疗费用虽然明显高于对照组,但总的住院费用及住院时间明显低于对照组,差异具有统计学意义(P<0.01);观察组患儿家属满意度为98.06%,明显高于对照组的88.35%,差异具有统计学意义(P<0.01)。结论平行轨道设计的临床路径入径率及完成率更高,便于临床操作,同时患者住院天数更少,总的费用更低,减轻了患者负担和医保资金的压力。

Objective To explore the feasibility and value of clinical pathway management on parallel-track design for pediatric bronchopneumonia with rotavirus enteritis.Methods A total of 206 cases of pediatric bronchopneumonia with rotavirus enteritis treated from September 2017 to October 2018 were randomly divided into control group and observation group(n=103,each).The traditional clinical pathway method was adopted in control group,while the clinical pathway on parallel-track design was performed in observation group.The access rate,completion rate,hospitalization expenses and hospital stay were compared between two groups.Results The clinical access rate(92.23%vs 65.04%)and completion rate(78.64%vs 27.18%)in observation group were significantly higher than those in control group(P<0.01).The total hospitalization expense and the hospitalization time in observation group were significantly lower than those in control group(P<0.01),even though the average daily treatment cost was obviously higher than that in control group.The satisfaction degree of family member in observation group was significantly higher than that in control group(98.06%vs 88.35%,P<0.01).Conclusion The clinical access rate and completion rate of parallel-track design is higher and convenient for clinical operation in pediatric bronchopneumonia with rotavirus enteritis.Meanwhile,the patients have fewer days in hospital and lower total cost.