基于单病种质量控制的急性心肌梗死临床路径优化效果评价

Effect Evaluation of Clinical Pathway Optimization for Acute Myocardial Infarction Based on Single Disease Quality Control

目的探讨急性心肌梗死(AMI)临床路径管理优化方案的效果。方法回顾性收集2021年1月~2022年3月大同市第三人民医院出院患者,根据临床路径优化前后的不同阶段,分别随机抽取AMI病例,对照组选取2021年1月~2021年6月优化前纳入临床路径管理的204例患者,研究组选取2021年11月~2022年3月优化后纳入临床路径管理的225例患者。比较两组患者平均住院天数、平均住院费用、费用结构以及疾病转归等指标。结果研究组的住院总费用低于对照组,差异有统计学意义(P<0.05),研究组费用结构中治疗费、手术费、药费低于对照组,研究组检查费高于对照组,差异均有统计学意义(P<0.05);研究组患者转归好转率高于对照组,差异有统计学意义(P<0.05)。结论基于单病种质量控制优化临床路径,可以规范诊疗行为、促进合理检查、合理用药,控制医疗费用。

Objective To explore the optimal plan and effect of clinical pathway management for patients with acute myocardial infarction(AMI).Methods AMI patients discharged from the Third People’s Hospital of Datong from January 2021 to March 2022 were collected.AMI cases were randomly selected in stages among patients included in the clinical pathway management according to the diff erent times before and after optimization.The study group selected 204 patients included in the clinical pathway management one year before the implementation of the optimization(January 2021 to June 2021)were selected in the control group.The control group selected 225 patients included in the clinical pathway after implementing the optimization(November 2021 to March 2022).The mean hospitalization days,mean total hospitalization cost and the cost structure,and disease regression of patients in the two groups were compared and evaluated.Results The total hospitalization cost was lower than that of the control group,which was statistically significant(P<0.05).The treatment cost,operation cost and drug cost were lower in the study group than in the control group,and the diff erence was significant(P<0.05).The improvement rate of the transferred study group was higher than that of the control group,which was significant(P<0.05).Conclusion The optimization of the clinical path based on the quality management of single disease can standardize the diagnosis and treatment behavior,promote rational examination and rational drug use,and reduce medical costs.