卫生经济研究
衛生經濟研究
위생경제연구
HEALTH ECONOMICS RESEARCH
2015年
7期
43-47
,共5页
临床路径%变异分析%PDCA循环%乳腺癌
臨床路徑%變異分析%PDCA循環%乳腺癌
림상로경%변이분석%PDCA순배%유선암
clinical pathway%variation analysis%PDCA cycle%breast cancer
选取北京大学深圳医院2010年乳腺癌手术病例为对照组，2011-2014年乳腺癌手术临床路径病例为实验组，以变异分析提供的证据为基础，实施多个周期的PDCA循环，对乳腺癌临床路径进行质量改进。结果显示，通过PDCA循环，乳腺癌临床路径的实施效果得到明显改善：乳腺癌临床路径总变异率从64.23%下降到14.28%，变异频次从平均每例4.16次下降到2.26次；平均住院日从11.23天下降到8.29天；抗菌药物使用率从77.69%下降至8.70%；但是手术病人人均医疗费用从14976.2元增加到17357元。
選取北京大學深圳醫院2010年乳腺癌手術病例為對照組，2011-2014年乳腺癌手術臨床路徑病例為實驗組，以變異分析提供的證據為基礎，實施多箇週期的PDCA循環，對乳腺癌臨床路徑進行質量改進。結果顯示，通過PDCA循環，乳腺癌臨床路徑的實施效果得到明顯改善：乳腺癌臨床路徑總變異率從64.23%下降到14.28%，變異頻次從平均每例4.16次下降到2.26次；平均住院日從11.23天下降到8.29天；抗菌藥物使用率從77.69%下降至8.70%；但是手術病人人均醫療費用從14976.2元增加到17357元。
선취북경대학심수의원2010년유선암수술병례위대조조，2011-2014년유선암수술림상로경병례위실험조，이변이분석제공적증거위기출，실시다개주기적PDCA순배，대유선암림상로경진행질량개진。결과현시，통과PDCA순배，유선암림상로경적실시효과득도명현개선：유선암림상로경총변이솔종64.23%하강도14.28%，변이빈차종평균매례4.16차하강도2.26차；평균주원일종11.23천하강도8.29천；항균약물사용솔종77.69%하강지8.70%；단시수술병인인균의료비용종14976.2원증가도17357원。
In the survey, breast cancer surgery cases were selected in 2010 as the control group in Shenzhen Hospital of Peking University, while the breast cancer surgery by clinical pathway were selected as the experimental group from 2011 to 2014. The quality of clinical pathway of curing breast cancer was improved based on the evidence provided by variation analysis, through multiple periods of PDCA cycle implementation. The results showed that through the PDCA cycle, the effect of the implementation of clinical pathway of curing breast cancer was significantly improved: the total variation rate of breast cancer with clinical path decreased from 64.23% to 14.28%, and the variation frequency dropped from average 4.16 times per case to 2.26 times per case; the number of average hospitalized days decreased from 11.23 days to 8.29 days; the usage of anti-bacteria drug from declined 77.69% to 8.70%;but the medical expenditure per capita in surgical patients increased from 14976.2 yuan to 17357 yuan.
