精细化临床路径管理降低按疾病诊断相关组模式下妇科手术NC1-子宫手术病组费用的效果

Effect of refined clinical pathway management in reducing the cost of gynecological surgery NC1-uterine surgery group in the diagnosis related group model

目的探讨精细化临床路径管理在降低按疾病诊断相关组(DRG)模式下妇科手术NC1-子宫(除子宫腔内病变以外)手术病组费用的应用效果。方法选取2023年徐州市妇幼保健院因子宫病损行子宫切除术而纳入NC1-子宫手术病组的164例患者进行回顾性分析,其中2023年1月至4月未实施精细化临床路径管理的91例患者作为对照组,2023年7月至10月实施精细化临床路径管理的73例患者作为研究组。比较两组患者的住院费用、住院时间、治愈好转率等。结果两组患者治愈好转率和严重并发症发生率比较,差异无统计学意义(P>0.05);两组患者平均住院日和术前平均住院日比较,差异无统计学意义(P>0.05);两组患者次均综合医疗服务类费用和次均治疗类费用比较,差异无统计学意义(P>0.05)。研究组次均住院费用、次均药费、次均耗材费均低于对照组,差异有统计学意义(P<0.05)。结论通过精细化临床路径管理,在保障医疗安全的前提下,不以缩短住院时间、减少治疗费用为手段,而是通过合理使用药品耗材,能有效降低DRG模式下妇科手术NC1-子宫手术病组患者的住院费用,为患者提供高效优质的医疗服务。

Objective To investigate the effect of refined clinical pathway management in reducing the cost of gynecological surgery NC1-uterine(except intrauterine lesions)surgery group in the diagnosis related group(DRG)model.Methods A total of 164 patients who underwent hysterectomy due to uterine lesions in Xuzhou Maternal and Child Health Hospital in 2023 and were included in the NC1-uterine surgery disease group were selected for retrospective analysis,91 patients who did not implement refined clinical pathway management from January to April 2023 were selected as the control group,and 73 patients who implemented refined clinical pathway management from July to October 2023 were selected as the study group.The hospitalization cost,hospital stay and recovery rate were compared between the two groups.Results There were no significant differences in the recovery rate and the incidence of serious complications between the two groups(P>0.05).There were no significant differences between the average days in hospital and the average days in hospital before surgery between the two groups(P>0.05).There were no significant differences between the two groups in the cost of comprehensive medical service and the cost of treatment(P>0.05).The average hospitalization cost,average drug cost and average consumables cost of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Through refined clinical pathway management,under the premise of ensuring medical safety,the hospitalization cost of patients in the gynecological surgery NC1-uterine surgery group under DRG mode can be effectively reduced through rational use of drug consumables rather than shortening hospital stay and reducing treatment costs,so as to provide patients with efficient and high-quality medical services.