Objective: To assess changes of physicians' behavior and care quality for inpatients with inguinal hernia of less than 14 yeais old in county hospitals before and after introduction of clinical pathway and case梑ased payment. Methods: all cases of inguinal hernia of less than 14 years old before and after the pilot were .selected from both pilot and control hospitals. The quality of care, length of stay and antibiotic use are analyzed with PSM and DID. Results: After the pilot, the average length of stay and preoperative length of stay had declined for 1.56 and 0.11 days respectively. Days of using antibiotics had increased 0.79 days, The quality of medical services had not changed. Conclusion: The implementation of clinical pathway and payment method reform had improved hospital efficiency 1, and should be improved Combine with the situation before the hospital pilot.%目的:评估县级医院临床路径及支付方式改革试点后医疗行为和质量效果变化,为相关政策提供依据.方法:调取2010年1月-2011年7月项目医院与对照医院在试点前后的小儿腹殷沟疝全部病例,用倍差法来评价试点病种的医疗质量、住院日和抗生素使用情况.结果:试点后小儿腹股沟疝的平均住院日和术前平均住院日分别缩短了1.56和0.11天；抗生素使用天数延长了0.79天；医疗服务质量无变化.结论:临床路径及支付方式改革试点促使医院提高了效率,保证高质量的医疗服务,但应结合当地实际逐步完善.
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