临床路径管理对住院天数和住院费用的影响分析  

Impact Analysis of Clinical Pathway to the Hospitalization Days and Expenses

作　　者：乐新[1] 刘敏[1] 蒲春涛[1] 朱岁松[1] 

机构地区：[1]广东医科大学附属南山医院(深圳市南山区人民医院),深圳市518052

出　　处：《中国病案》2017年第5期31-33,共3页Chinese Medical Record

基　　金：深圳市科创委资助项目(JCY20130402151227186)

摘　　要：目的探讨临床路径管理对胆囊结石伴慢性胆囊炎患者住院天数和住院费用的影响,并评价临床路径在此病种医保付费中的应用价值。方法选取2013年1月-2016年6月深圳市某三甲医院收治的胆囊结石伴慢性胆囊炎患者作为研究对象,按入径、未入径分为临床路径组和对照组,采用回顾性分析比较两组医疗效率、效益指标的区别。结果临床路径组的平均住院日、术前住院天数、住院总费用、药费、检查费都低于对照组,P<0.05;材料费的差异无统计学意义,P>0.05。临床路径组中医保付费的住院总费用、药费、检查费与自费相比,差异具有统计学意义,P<0.05;除材料费外医保付费均低于自费方式。医保付费方式下临床路径组的药费、检查费低于未入路径组,差异均具有统计学意义,P<0.05;住院总费用、材料费的差异没有统计学意义,P>0.05。结论临床路径管理有一定优势,在医保付费中起到控制住院费用的积极作用。Objectives To explore the impact of clinical pathway on hospitalization days and expenses, and evaluate the value in medical insurance payment. Methods A total of 573 patients with cholecystolithiasis with chronic cholecystitis who treated in January 2013 to June 2016 were chosen and divided into two groups, clinical pathway group and control group, comparing and evaluating the difference in two groups. Results The difference of average hospitalization days, preoperative hospitalization days, total hospitalization expenses, expenses for medicine, examination cost were all statistically significant （P〈0. 05）between clinical pathway group and control group. In clinical pathway group, the difference of total hospitalization expenses, expenses for medicine, examination cost were statistically significant（P〈 0. 05）between the medical insurance payment and the self-financing mode. With medical insurance payment, the difference of expenses for medicine, examination cost were statistically significant（P〈0. 05）between the clinical pathway and the non-clinical pathway. Conclusions Clinical pathway management has certain advantages, and plays a positive role in controlling hospital costs with the medical insurance payment.

关 键 词：临床路径 胆囊结石伴慢性胆囊炎 住院天数 住院费用 

分 类 号：R197.32[医药卫生—卫生事业管理]