CAJ | 학술논문

目的探讨临床路径(CP)管理模式在单病种医疗质量管理中的作用.方法 2008年7月至2010年6月收治腹股沟疝患者84例,均行无张力疝修补术,住院过程接受CP管理的患者36例为观察组,其余未接受CP管理的患者48例为对照组1.同时,既往相等时间段内行腹股沟疝无张力疝修补术且能随访到的患者48例为对照组2.观察组所在科室组织、设计、实施腹股沟疝无张力疝修补术CP管理.观察组分别与2个对照组进行平均住院日、术前住院日、住院费用、总药费、药品收入占医院总收入的比例(药收比)、并发症发生率、治愈率、患者满意度评分及投诉率等医疗相关指标的比较.结果所有患者均手术成功,成功率100%,投诉率为0.观察组平均住院日、术前住院日均明显短于对照组1和对照组2[分别为(6.3±1.6)d比(8.9±3.1)、(9.6±5.7)d,(2.0±0.7)d比(2.5±1.3)、(2.9±1.9)d],并发症发生率明显降低[0比22.9%、14.6%],患者满意度评分明显增高[(99.3±2.0)分比(90.1±14.3)、(91.3±12.6)分],差异有统计学意义(均P<0.05).观察组总药费及药收比较对照组1明显减少,平均住院费用较对照组2明显减少,差异有统计学意义.结论实施CP管理,可优化诊疗流程,规范医疗行为,提高医疗工作效率,合理利用医疗资源,提高医疗质量.
목적 탐토림상로경(CP)관리모식재단병충의료질량관리중적작용.방법 2008년7월지2010년6월수치복고구산환자84례,균행무장력산수보술,주원과정접수CP관리적환자36례위관찰조,기여미접수CP관리적환자48례위대조조1.동시,기왕상등시간단내행복고구산무장력산수보술차능수방도적환자48례위대조조2.관찰조소재과실조직、설계、실시복고구산무장력산수보술CP관리.관찰조분별여2개대조조진행평균주원일、술전주원일、주원비용、총약비、약품수입점의원총수입적비례(약수비)、병발증발생솔、치유솔、환자만의도평분급투소솔등의료상관지표적비교.결과 소유환자균수술성공,성공솔100%,투소솔위0.관찰조평균주원일、술전주원일균명현단우대조조1화대조조2[분별위(6.3±1.6)d비(8.9±3.1)、(9.6±5.7)d,(2.0±0.7)d비(2.5±1.3)、(2.9±1.9)d],병발증발생솔명현강저[0비22.9%、14.6%],환자만의도평분명현증고[(99.3±2.0)분비(90.1±14.3)、(91.3±12.6)분],차이유통계학의의(균P<0.05).관찰조총약비급약수비교대조조1명현감소,평균주원비용교대조조2명현감소,차이유통계학의의.결론 실시CP관리,가우화진료류정,규범의료행위,제고의료공작효솔,합리이용의료자원,제고의료질량.
Objective To explore the effects of clinical pathway ( CP) management model in medical quality management of single disease. Methods From July 2008 to June 2010, 84 cases of inguinal hernia were treated by tension-free hernioplasty. The observation group receiving CP management had 36 cases of inguinal hernia tension-free hemioplasty according to the standard of single disease and other patients were assigned to control group 1. Meanwhile 48 cases of inguinal hernia tension-free hernioplasty were followed as control group 2 which did not have the management of CP. The differences of health-related indicators, such as the average length of hospital stay, the days waiting for surgery, hospital costs, general medicine costs, drug income ratio, recovery ratio, complication ratio, patient satisfaction scores and complaints ratio, were analyzed. Results The average length of stay and the days waiting for surgery in observation group was significantly shorter than those the control group 1 and group 2 [(6.3±1.6)dvs (9.6±5.7),(8.9±3.1)d;(2.0±0.7)dvs (2.9 ±1.9) ,(2.5 ± 1.3)d] ;the incidence of complications decreased[0 vs 14. 6% (7/48) , 22. 9% (11/48)] and patient satisfaction scores increased[(99. 3 ± 2.0) vs (91.3 ± 12.6) , (90.3 ± 14.3)]. On the other hand, the general medicine costs and drug-income ratio in the observation group were much lower than those in control group 1 and the average hospital cost in the observation group was much lower than that in control group 2. All differences between the observation group and the control groups were statistically significant. Conclusion Adopting CP management can optimize treatment process, standardize medical care, improve health care efficiency and actualize rational use of medical resources.