临床路径管理对脑梗死患者住院费用的影响研究

Study on the Influence of Clinical Pathway Management on Hospitalization Expenses of Patients with Cerebral Infarction

目的:探讨临床路径管理对脑梗死患者住院费用的影响。方法:利用S医院因脑梗死入院的患者病案首页数据,进行方差分析、卡方检验和多元线性回归分析。结果:影响临床路径入组的因素仅有疾病分型,控制其他因素影响后,临床路径组住院费用比非临床路径组高1767.17元(P=0.028)、药费高1423.83元(P<0.001),但医嘱离院占比无显著变化、平均住院日和住院费用的变异系数降低,临床路径调节疾病特征对住院费用影响的效应不显著。结论:临床路径管理侧重于提质而非增效,并不必然带来医疗费用降低,要多措并举推动临床路径管理高质量落地。

Objective To explore the influence of clinical pathway management on hospitalization expense of patients with cerebral infarction.Methods By the data on the first page of medical records of 1078 patients in S hospital in 2019,analysis of variance,chi-square test and multiple linear regression analysis were used.Results The only factor affecting the clinical pathway implementation was the subtypes of disease.After controlling effects of other factors,the hospitalization expenses of the clinical pathway group was 1767.17 yuan higher than that of the non-clinical pathway group(P=0.028).Among them,the drug cost of the clinical pathway group was 1423.83 yuan higher than that of the non-clinical pathway group(P<0.001),but there was no significant change in the proportion of medical advice to leave the hospital,the coefficient of variation of average hospitalization days and hospitalization expenses decreased,and the effect of clinical pathway regulating disease characteristics on hospitalization expenses was not significant.Conclusion Clinical pathway management focuses on improving quality rather than increasing efficiency,which does not necessarily lead to a reduction in medical expenses.Multiple measures should be taken to promote the high-quality implementation of clinical pathway management.