目的 研究临床路径管理模式在医院质量管理中对合理用药和医疗质量效果的评价.方法 选择2010年5月-2012年8月住院的适合实施临床路径管理的患者,包括上消化道出血等19个病种1 355例作为观察组,选择同时期未曾实施临床路径的患上述同样疾病的1 054例作为对照组.结果 观察组的住院总费、药物总费、抗生素费、住院时间、抗生素使用时间及药物品种数((x)±s)低于对照组(P＜0.05);药物总费/住院总费、抗生素费/药物总费、抗生素费/住院总费((x)±s)在观察组较对照组明显下降(P＜ 0.05); 14日或31日再住院率、并发症发生率和手术部位感染率,观察组均小于对照组,差异没有统计学意义(P＞0.05).结论 临床路径作为一种质量效益型医疗管理模式,有效地监控及指导药物的合理使用,促进医疗质量不断提高.%Objective To study the effect of the clinical path model on rational medicine use and the evaluation of treatment quality in hospital quality management.Methods 1 355 patients of 19 kinds of the diseases,such as upper gastrointestinal bleeding,treated by clinical path procedure,were selected as observation group from March 2010 to Augusl 2012.1 054 patients with the same diseases above in the same period,given the same treatment measures as observation group without introducing clinical path procedure,were selected as the control group.Results The means ((x)±s) of the hospitalization length,hospital expense,medicine expense,auti-bacteria costs,length of using auti-bacteria,typical number of using drugs in the observation group were significantly lower than that of the control group,and the differences were significant (P＜0.05).The means ((x)±s),including the rate of medicine expense to hospital expense,the rate of auti-bacteria costs to medicine expense and the rate of auti-bacteria medicine costs to hospital expense in the observation group,were also significantly lower than that of the control group,and there were significant differences (P＜0.05).The re-hospitalization rate of 14 days or 31 days,complication rate and infection rate of operation site of observation group were respectively lower than that of the control group,but the differences were not significant (P＞0.05).Conclusion Clinical pathway is a medical management model of quality and efficiency,which is effective and reasonable in keeping medicine from abusing.
展开▼
