临床路径信息系统设计与应用  

Design and Application of Information System in Clinical Pathway

作　　者：董军[1] 李军[1] 周亚春[1] 高云飞[1] 张赞[1] 

机构地区：[1]天津泰达国际血管病医院,天津300457

出　　处：《中国卫生质量管理》2007年第2期67-70,共4页Chinese Health Quality Management

摘　　要：临床路径是一种按照住院天数将特定病种的诊疗项目内容进行标准化的诊疗计划。临床路径信息系统是建立在医院信息系统基础上的诊疗信息系统,其主要功能包括:(1)标准设置。包括诊疗、时限、规章制度以及费用4大标准的设定以及按住院天数展开各项标准内容。(2)路径执行与控制。路径准入后,严格执行标准医嘱和路径表单中的非医嘱类的各项规章制度或宣教内容。(3)路径的差异与变异分析。对照标准自动分析差异,并进行变异处理与分析。(4)统计分析与评估。评估每一例病案的住院天数、诊疗项目和医疗费用的执行情况,总结变异原因,改进路径标准。Clinical Pathway is a medical plan which standardizes the treatments of special diseases according to hospital days. Clinical Pathway information system is a medical information system on the basis of hospital information system, its main functions include ： （ 1 ） Set up standards, which include four standards： treatments, time limited, rules and regulations, charge, and carry out each content of standards according to hospital days. （2） Do and control the paths. If patient is admitted to the path, standard orders and other rules and regulations or education must be carried out strictly. （ 3 ） The difference of paths and variation analysis. The different is analyzed automatically compared with standard, and variation is analyzed and treated. （4） Statistical analysis and evaluation. The length of stay, medical items, and medical spend of each case is evaluated ; the reason of variation is summarized to improve the standard of paths.

关 键 词：临床路径 信息 

分 类 号：R197.324[医药卫生—卫生事业管理]