某院部分病种临床路径的管理成效分析

Analysis on the Effectiveness of Clinical Pathway Management for Some Diseases in a Hospital Y

目的结合疾病自身特点探讨临床路径管理成效,为临床路径管理成效分析提供依据。方法随机抽取信息系统中2016年1月1日-2016年12月31日诊断为新生儿高胆红素血症、轮状病毒肠炎、运动发育落后,符合ICD-10疾病编码且符合纳入临床路径诊断标准,每个病种100例,共300例作为对照组,随机抽取2017年1月1日-2017年12月31日收治同诊断入组临床路径患儿,每个病种100例,共300例作为临床路径组。采集信息系统中2组患儿的平均住院时间、平均住院总费用、平均药品费用数据。结果执行临床路径后不同疾病平均住院时间、住院总费用、药品费用均有不同的变化趋势。新生儿高胆红素血症诊断2组患儿CP组住院时间较对照组延长1.48天,平均药品费用较对照组减少482.70元,差异具有统计学意义,P<0.05,轮状病毒肠炎诊断2组患儿CP组平均总住院费用较对照组减少1027.55元,CP组的平均药品费用较对照组增加754.96元,差异具有统计学意义,P<0.05,运动发育落后诊断2组患儿CP组平均总住院费用较对照组增加996.92元,CP组的平均药品费用较对照组减少554.59元,差异有统计学意义,P<0.05。结论在临床路径的应用过程中,不同疾病的临床路径造成管理成效的不同,在今后的设计中结合临床特点进行临床路径设计及成效评估。

t Objectives Combined with the characteristics of the disease itself to explore the effectiveness of clinical pathway management,to provide a basis for the analysis of clinical pathway management effectiveness.Methods From January 1st,2016 to December 31st,2016,neonatal hyperbilirubinemia,rotavirus enteritis,and motor retardation were randomly selected from the information system,meeting the ICD-10 disease code and the criteria for inclusion in the clinical pathway.100 cases of each disease and a total of 300 cases were selected as the control group.Children admitted from January 1st,2017 to December 31st,2017 with the same diagnosis in the clinical pathway group were randomly selected,with 100 cases for each disease category,and a total of 300 cases were selected as the clinical pathway group.The average length of hospital stay,average total hospitalization cost and average drug cost of the two groups were collected from the information system.Results The average length of hospital stay,total hospital expenses and drug expenses of different diseases had different trends after the implementation of clinical pathway.Compared with the control group,the hospital stay in CP group of the 2 groups diagnosed with neonatal hyperbilirubinemia was extended by 1.48 days,and the average drug cost was reduced by 482.70 yuan,the difference was statistically significant(P<0.05).The average total hospital cost in CP group of the 2 groups diagnosed with rotavirus enteritis was reduced by 1027.55 yuan compared with the control group.Compared with the control group,the average drug cost in CP group increased by 754.96 yuan,the difference was statistically significant,P<0.05,the average total hospital cost in CP group increased by 996.92 yuan compared with the control group,and the average drug cost in CP group decreased by 554.59 yuan compared with the control group,the difference was statistically significant,P<0.05.Conclusions In the application process of clinical pathways,clinical pathways of different diseases lead to different management effectiveness.Clinical pathways design and effectiveness evaluation should be carried out in combination with clinical characteristics in future design.