我国临床路径评价指标的循证分析  

Evaluation Index of Clinical Pathways in China:A Systematic Review

作　　者：张伟旋[1,2] 夏萍[2] 吴大嵘[2] 蔡坚雄[2] 焦雅辉[3] 李大川[3] 程兰[2] 黄雪莹[4] 袁秀琴[2] 张晋昕[1] 

机构地区：[1]中山大学公共卫生学院,广州510080 [2]广东省中医院,广州510120 [3]卫生部医政司,北京100044 [4]广州医学院第二附属医院,广州510260

出　　处：《中国循证医学杂志》2012年第6期651-655,共5页Chinese Journal of Evidence-based Medicine

基　　金：中国医院协会2009~2010年度医院管理研究课题(编号:CHA-3-2010-036);国家中医药管理局公益性行业科研专项(编号:200707004)

摘　　要：目的循证评析我国临床路径评价指标的应用现状,以期为构建我国临床路径评价指标体系提供参考。方法计算机检索CBM、VIP、WanFang Data及相关官方网站,系统收集与我国临床路径管理评价指标相关文献。文献检索时限为2004年1月1日～2009年12月31日。结果共纳入文献1 175篇,其中在核心期刊发表135篇(11%),硕士学位论文19篇(2%),其他文献1 021篇。在核心期刊发表的135篇文献及19篇硕士学位论文中,属于2级证据文献共148篇,占总文献量的96%。对指标名称的分析结果显示,指标内涵相同,但名称不一致的比例达87%;指标合并汇总后得到的共性指标集中在成本指标、临床指标、服务指标、质量评估四个方面。本次纳入研究的1 175篇临床路径评价文献,多侧重护理和教育宣教方面的应用,达78%,其中仅有1篇硕士学位论文在选择评价指标时使用了德尔菲法、专家小组讨论、专家打分法(百分制)等社会研究方法。结论现有国内临床路径评价指标研究存在文献的方法学质量不高,临床路径评价指标统计术语使用不规范性和随意性较大,以及缺乏对构建临床路径评价指标体系的研究等问题。Objective To analyze and evaluate the present status of application of clinical pathway evaluation indexes in China, in order to provide references to establish an evaluation system on clinical pathway. Methods Such databases as CBM （2004-2009）, VIP （2004-2009）, CNKI （2004-2009） and WanFang Data （2004-2009）, and some relevant websites were searched systematically for collecting Chinese literature about domestic clinical pathway evaluation indexes. Results Among the 1 175 articles included, 135 （11%） were published in the core periodicals, 19 （2%） were masterate theses, and 1 021 were other kinds of articles. As to 135 core periodical literature and 19 masterate theses, most of which were graded into the second level of evidence, accounting for 96%. The analysis on the appearance of indexes showed that 87% of inconsistency could be identified between the contents and terms of indexes. Common indexes were summarized as the following four aspects： cost index, clinical index, serving index and quality evaluation index. There were 78% of all the 1 175 articles focusing on the application of nursing and medical education, in which only one masterate thesis used social research methods such as Delphi, focus group, experts scoring （percentile）, etc. Condusion Currently, there are some issues existing in the evaluation indexes of clinical pathway in China, such as low methodological quality of litera- ture, irregularly and randomly using statistical terms, and lack of studies on system construction of clinical pathway evalu- ation indexes.

关 键 词：临床路径 循证分析 

分 类 号：R47[医药卫生—护理学]