临床路径管理在基层医院推广应用的瓶颈探讨

摘要

With the change of government to hospital payment policy, promotion and application of prospective payment system and in the premise of fixed medical expense payment, the examination, inspection or operation and treatment dispos-al are benefits instead of costs, each increase of treatment disposal can make the treatment institution cost increase and profit decrease, in this background, many medical institutions have already begun to introduce the clinical pathway concept in order to ensure the medical quality and improve the clinical benefits. the implementation of clinical pathway management in the medical institutions in the middle-sized and small cities has just started due to the obvious difference in the regional development, and there are many issues to research and solve, at present, the wide implementation of clinical pathway still has some difficulties, and the promotion and application of it in the primary hospital has a certain resistance, seriously re-stricting the normal development of clinical pathway management. The paper studies the main bottleneck in the promotion of clinical pathway in the primary hospital-effect of information technology on the clinical pathway management from the as-pect of the bottleneck of restricting the promotion of clinical pathway in the primary hospital and how to break through the information construction.%随着政府对医院支付政策的改变，前瞻性支付制度的推广应用，在医疗费用给付固定的前提下，检查、检验或手术与治疗处置不再是效益而是成本，每增加一项治疗处置，就要使治疗机构的成本增加，利润下降。在这种背景条件下，为保证医疗质量，提高临床效益，不少国家的医疗机构都早已开始引进临床路径的概念。由于我国地区发展差异较为明显，中小城市医疗机构中实行临床路径管理刚刚起步，还有不少问题需要研究和解决。目前临床路径的广泛实施尚存在一些困难，其在基层医院的推广应用存在一定的阻力，严重制约着临床路径管理的正常开展。该文主要从制约临床路径在基层医院推广的瓶颈及如何突破信息化建设方面，探讨了基层医院推广临床路径遇到的主要瓶颈---信息技术对临床路径管理的影响。