CAJ | 학술논문

目的通过对新型农村合作医疗(新农合)单病种管理实施临床路径应用的观察来评价临床路径的价值与作用.方法根据选择病种的原则我们选择进行阑尾炎、腹股沟疝手术治疗的患者各60例,同一病种患者按实行临床路径单病种管理与否分为试验组和对照组各30例.对每一病种的2组患者进行平均住院日、平均住院费用、患者满意度等几个方面的比较.结果阑尾炎患者实施了临床路径管理后,试验组平均住院日比对照组缩短了约2.5 d,平均住院费用减少了约1602.4元,差异均有统计学意义(P＜0.05).腹股沟疝患者实施了临床路径管理后,试验组的平均住院日缩短了约3.4 d,平均等候手术日缩短了约1.5 d,平均住院费用减少了约1789.7元,差异均有统计学意义(P＜0.05).在阑尾炎患者中,对照组药品费用比例、抗生素费用比例明显高于试验组,实验室检查和影像检查费比例比试验组偏高,差异均有统计学意义(P＜0.05).在腹股沟疝患者中,对照组药品费用比例、实验室检查和影像检查费用所占比例均明显高于试验组,差异有统计学意义(P＜0.05).结论临床路径提供了标准规范的工作模式,能保证医疗护理等措施在既定时间内实现,并达到预期的医疗效果,还能促进医疗资源的有效利用,使参合农民及所有患者受益.
목적 통과대신형농촌합작의료(신농합)단병충관리실시림상로경응용적관찰래평개림상로경적개치여작용.방법 근거선택병충적원칙아문선택진행란미염、복고구산수술치료적환자각60례,동일병충환자안실행림상로경단병충관리여부분위시험조화대조조각30례.대매일병충적2조환자진행평균주원일、평균주원비용、환자만의도등궤개방면적비교.결과 란미염환자실시료림상로경관리후,시험조평균주원일비대조조축단료약2.5 d,평균주원비용감소료약1602.4원,차이균유통계학의의(P＜0.05).복고구산환자실시료림상로경관리후,시험조적평균주원일축단료약3.4 d,평균등후수술일축단료약1.5 d,평균주원비용감소료약1789.7원,차이균유통계학의의(P＜0.05).재란미염환자중,대조조약품비용비례、항생소비용비례명현고우시험조,실험실검사화영상검사비비례비시험조편고,차이균유통계학의의(P＜0.05).재복고구산환자중,대조조약품비용비례、실험실검사화영상검사비용소점비례균명현고우시험조,차이유통계학의의(P＜0.05).결론 림상로경제공료표준규범적공작모식,능보증의료호리등조시재기정시간내실현,병체도예기적의료효과,환능촉진의료자원적유효이용,사삼합농민급소유환자수익.
Objective To evaluate the value and the function of clinical pathway by observing the application of carrying out clinical pathway of the management of single-disease in the new cooperative medical scheme. Methods According to the roles of choosing the kind of disease,patients who had been treated by appendicitis operation and inguinal hernia operation were chosen. Each group had 60 cases respectively. Patients who had the same disease were divided into experimental group and control group. The average days in hospital,the average hospitalization expenses,the satisfaction of patients were compared between two groups. Results Through the implementation of clinical pathways,the average days in hospital and hospitalization expenses of appendicitis patients were significantly reduced (P ＜ 0.05),those of inguinal hernia patients were also significantly reduced (P ＜ 0.05). For appendicitis patients in the control group,the proportion of drug costs and antibiotics were significantly higher than those in the experimental group. The proportion of laboratory tests and imaging examination were significantly lower than that in the experimental group (P ＜0.05). For inguinal hernia patients in the control group,the proportion of drug costs,laboratory tests and imaging examination were significantly higher than the experimental group (P ＜0.05). Conclusions Clinical pathway provides a standard operating mode and ensures the implementation of health care measures,so the expected medical effects can be achieved. It can promote the effective use of medical resources,benefitting both the patients and the farmers who participate the new cooperative medical scheme.