临床路径对合理用药和医疗质量评价的相关性研究  

Research of Effect of Clinical Path on Rational Medicine Use and Evaluation of Treatment Quality

作　　者：马国胜[1] 蔡曦光[1] 孟永洁[1] 张东[1] 唐淑玲[1] 刘小霞[1] 包雅琴 陈延平[1] 柏燕[1] 

机构地区：[1]甘肃省人民医院,甘肃兰州730000

出　　处：《中国医院管理》2013年第2期34-36,共3页Chinese Hospital Management

基　　金：甘肃省卫生行业科研计划管理项目(GWGL2011-5)

摘　　要：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 treat- ment quality in hospital quality management. Methods 1 355 patients of 19 kinas of the diseases, such as upper gastroin- testinal bleeding, treated by clinical path procedure, were selected as observation group from March 2010 to August 2012. 1 054 patients with the same diseases above in the same Deriod. given the same treatment measures as observa- tion group without introducing clinical path procedure, were selected as the control group. Results The means （.^-~~） of the hospitalization length, hospital expense, medicine expense, auti-bacteria costs, length of using auti-bacteria, typ- ical number of using drugs in the observation group were significantly lower than that of the control group, and the differ- ences 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 s^gnificant differences （P〈0.05） . The re-hospitalization rate of 14 days or 31 days, complication rate and infection rate of operation site of ob- servation 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 rea- sonable in keeping medicine from abusing.

关 键 词：临床路径 合理用药 医疗质量 评价指标 

分 类 号：R197.3[医药卫生—卫生事业管理]