CAJ | 학술논문

目的：探讨不同医疗保险支付方式对实施临床路径管理的影响。方法从2014年1~2月河北北方学院附属第一医院收治的2型糖尿病、慢性鼻-鼻窦炎、胆囊结石腹腔镜胆囊切除术患者中随机选择200例，按医疗保险支付方式的不同分为观察组和对照组，每组100例。观察组实行按病种付费制，对照组实行按总额预付制，两组均实施临床路径管理。比较两组住院时间、住院费用，以及患者对疾病的掌握程度、满意度。结果观察组患者住院费用明显少于对照组，住院时间显著短于对照组，差异均有统计学意义(均P<0.05)；观察组患者知识掌握得分为(94.4±1.8)分，对照组患者知识掌握得分为(84.3±0.7)分，差异有统计学意义(P<0.05)；观察组患者满意度为94%，明显高于对照组的76%，差异有统计学差异(P<0.05)。结论按病种付费制度的医疗保险模式可为患者缩短医疗时间，节约医疗成本，与临床实施临床路径管理互相促进，值得临床推广。
목적：탐토불동의료보험지부방식대실시림상로경관리적영향。방법종2014년1~2월하북북방학원부속제일의원수치적2형당뇨병、만성비-비두염、담낭결석복강경담낭절제술환자중수궤선택200례，안의료보험지부방식적불동분위관찰조화대조조，매조100례。관찰조실행안병충부비제，대조조실행안총액예부제，량조균실시림상로경관리。비교량조주원시간、주원비용，이급환자대질병적장악정도、만의도。결과관찰조환자주원비용명현소우대조조，주원시간현저단우대조조，차이균유통계학의의(균P<0.05)；관찰조환자지식장악득분위(94.4±1.8)분，대조조환자지식장악득분위(84.3±0.7)분，차이유통계학의의(P<0.05)；관찰조환자만의도위94%，명현고우대조조적76%，차이유통계학차이(P<0.05)。결론안병충부비제도적의료보험모식가위환자축단의료시간，절약의료성본，여림상실시림상로경관리호상촉진，치득림상추엄。
Objective To investigate the effects of different medical insurance payment on the implementation of clini-cal pathway management. Methods 200 cases of patients with type 2 diabetes mellitus, chronic rhinosinusitis, gallstone undergoing laparoscopic cholecystectomy from January to February 2014 in the First Affiliated Hospital of Hebei North University were randomly selected. According to the medical insurance payment, the cases were divided into observa-tion group and control group, 100 cases in each group. Observation group was given payment by type of disease, control group was given the total amount of the advance system. The two groups were given clinical pathway management. The hospitalization days, hospitalization expenses, mastery degree of knowledge, satisfaction in two groups were compared. Results The hospitalization expenses in the observation group was significantly lower than the control group, hospital-ization time was shorter than control group, the differences were all statistically significant (P<0.05). The mastery de-gree of knowledge in the observation group was (94.4±1.8) scores, which in the control group was (84.3±0.7) scores, the difference was statistically significant (P<0.05). The satisfaction degree was 94%in the observation group, significant-ly higher than that in the control group (76%), the difference was statistically significant (P<0.05). Conclusion The mode of medical insurance payment system can shorten the medical time-out and save medical cost for patients, also can promote clinical pathway management. It is worthy of clinical promotion.