低成本腹腔镜阑尾切除术在临床路径单病种限额付费中的可行性分析  

Analysis on feasibility of low-cost laparoscopic appendectomy in clinical pathway of single disease quota payment

作　　者：王宗洪[1] 周檎 

机构地区：[1]什邡市人民医院普外科,四川618400

出　　处：《现代医药卫生》2016年第10期1454-1456,共3页Journal of Modern Medicine & Health

摘　　要：目的评价低成本腹腔镜阑尾切除术在临床路径定额付费中的可行性。方法回顾性分析该院2015年1~11月进入临床路径行阑尾切除术的急性阑尾炎患者100例,将其随机分为研究组和对照组,各50例。研究组患者采用单极电凝行低成本腹腔镜阑尾切除术;对照组患者采用传统的开腹阑尾切除术。分别比较两组患者平均住院费用、平均住院时间、路径变异率和患者满意度。结果研究组平均住院时间和路径变异率明显减少,患者满意度明显提高,差异均有统计学意义（P〈0.05）。而两组平均住院费用比较,差异无统计学意义（P〉0.05）。结论采用单极电凝法低成本腹腔镜阑尾切除术在临床路径限额费用中应用是可行的,且在平均住院时间、路径变异率、患者满意度方面均优于传统开腹手术,值得在临床推广。Objective To evaluate the feasibility of low-cost laparoscopic appendectomy in the clinical pathway of single disease quota payment. Methods A total of 100 cases of acute appendicitis performing appendectomy by the clinical pathway in our hospital from January to November 2015 were retrospectively analyzed and randomly divided into the study group and the con-trol group,50 cases in each group. The study group adopted the low-cost laparoscopic appendectomy by monopolar electrocoagu-lation,while the control group adopted the traditional open appendectomy. The average hospitalization costs ,average hospitaliza-tion days,pathway change rate and patient′s satisfaction were compared between the two groups. Results Compared with the control group,the average hospitalization days and pathway change rate in the study group were significantly decreased , and the patient′s satisfaction was significantly improved,the differences were statistically significant（P〈0.05）,but the average hospitaliza-tion costs had no statistical difference between the two groups（P〉0.05）. Conclusion Adopting the low-cost laparoscopic appen-dectomy by the monopolar electrocoagulation is feasible in the clinical pathway of single disease quota pay ,is superior to the tra-ditional open appendectomy in the aspects of the average hospitalization time ,pathway change rate and the patient′s satisfaction and deserves to be clinically promoted.

关 键 词：阑尾切除术 腹腔镜检查 临床路径 费用 医疗 电凝术 

分 类 号：R656.8[医药卫生—外科学]