[1]关翎郭昱君杨燕绥邱亨嘉.临床路径优化卫生资源的分析研究[J].中国卫生质量管理,2020,27(01):39-43.[doi:10.13912/j.cnki.chqm.2020.27.1.10]

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临床路径优化卫生资源的分析研究

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 第27卷期数: 2020年01期页码: 39-43 栏目: 医疗质量出版日期: 2020-01-28

作者:: 关翎郭昱君杨燕绥邱亨嘉; 清华大学医院管理研究院

关键词:: 临床路径; 卫生资源; 住院天数; 住院费用; 变异系数

Keywords:: Clinical Pathway; Health Resources; Length of Stay; Cost of Hospitalization; Coefficient Variation

DOI:: 10.13912/j.cnki.chqm.2020.27.1.10

摘要:: 目的评价脑梗死临床路径对卫生资源使用的影响。方法采集深圳市7家公立医院病例数据1 950例，排除不完整数据，纳入1 913个符合第一诊断为脑梗死的病例进行分析，其中临床路径组746例，非临床路径组1 167例。自变量为有无临床路径,因变量分别有住院天数、住院总费用以及7项细项费用。统计方法为非参数检验、卡方检定、变异系数分析。结果住院天数(10.47日VS 10.63日)与住院费用(15 701.2 RMB VS 14 823.0 RMB)在两组间无显著差异，但临床路径组住院天数及所有费用指标的变异系数均小于非临床路径组。结论临床路径组较非路径组的离散数值相对较低，显示临床路径能够使脑梗死病例获得最佳的卫生资源分配。

Abstract:: ObjectiveTo evaluate the effect of clinical pathway on health resources utilizations for the patients who were diagnosed with cerebral infarction (CI).Methods1 950 patients were identified from 7 public hospitals of Shenzhen city. The patient without a complete medical insurance information should be excluded so that 1 913 cases meeting the first diagnosis of CI were applied for the analysis in finally. Patients had been classified into two groups: clinical pathway (CP) group (n=746) and non-clinical pathway group (Non-CP, n=1 167). Outcome variables were hospital length of stay, hospitalization expenses and seven detailed expenses. Nonparametric test，χ2 test，and coefficient variation (CV) were used in analysis. ResultsThere were no statistically significant difference between CP and non-CP group in length of stay (10.47 days vs.10.63 days)and total hospitalization expense (15 701.2 RMB vs. 14 823.0 RMB). But the coefficient variations (CV) of the length of stay and all items of hospitalization expense in CP group were smaller than that of in non-CP. Conclusion The coefficient variation (CV) of each item in CP was smaller than that of the non-CP group, which indicated that the implementation of clinical pathway could enable optimal allocation of health resources for CI patients.

参考文献/References:

［1］Vanhaecht K, De WK, Panella M, et al.Do pathways lead to better organized care processes［J］.Journal of Evaluation in Clinical Practice，2009，15: 782.

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更新日期/Last Update: 2020-01-28