耳鼻喉专科临床路径管理应用效果评价与分析

摘要

Objective To explore the effect of the clinical path management in treatment of vocal cord polyp and chronic tonsillitis,to provide the scientific advice for the standardization, regulation and homogeneity of the ear-nose-throat (ENT)single disease treatment.Methods A retrospective cohort study from Suining Center Hospital was applied to compare the status between traditional group and the clinical pathway group.The main evaluation indicators included hospital cost,hospitalization day and treatment effects.Results The differences of basic situation such as vocal cord polyp and chronic tonsillitis between the clinical pathway group and the control group were not significant (P>0.05).The average total cost of hospitalization,inspection fee, surgery fee,drugs fee,other treatment charge and the average hospitalization day of the vocal cord polyp clinical pathway group were less than those of the control group (P<0.05);the average total cost of hospitalization,inspection fee,surgery fee,drugs fee,nursing fee,other treatment charge and the average hospitalization day of the chronic tonsillitis clinical pathway group were less than those of the control group (P<0.01);Clinical curative effect between the vocal cord polyp clinical pathway group and the control group were not significant (P>0.05 );Clinical curative effect of chronic tonsillitis patients path group was higher (P<0.05 ),whereas the incidence of hospital complications,infection,between the path and control group were no significant (P>0.05).Conclusion Clinical path management can shorten the average length of hospitalization,reduce the hospital cost and improve the quality of diagnosis and treatment to help standardize the treatment of ENT diseases.%目的：观察临床路径管理在耳鼻喉专科声带息肉和慢性扁桃体炎治疗中应用效果，为耳鼻喉专科单病种的标准化、规范化、同质化治疗提供依据。方法采用回顾性队列研究设计，选择临床路径实施前入院的声带息肉和慢性扁桃体炎患者为对照组，实施临床路径的患者为临床路径组；分析2组患者的住院费用、住院时间、诊疗质量等指标。结果临床路径组与对照组患者基本情况差异均无统计学意义（P＞0．05），具有可比性。临床路径组声带息肉患者平均住院总费用、检查费、手术费、药费、其他费用和平均住院时间均少于对照组（P＜0．01）；临床路径组慢性扁桃体炎患者的平均住院总费用、检查费、手术费、药费、治疗护理费、其他费用和平均住院时间均少于对照组（P＜0．01）。声带息肉患者的临床疗效在临床路径组与对照组之间差异无统计学意义（P＞0．05）；慢性扁桃体炎患者临床疗效临床路径组高于对照组（P＜0．05），而住院并发症发生率差异无统计学意义（P＞0．05）。结论临床路径管理可以缩短平均住院时间、降低住院费用、提高诊疗质量，有助于耳鼻喉科疾病的规范化、标准化、同质化治疗。