基于临床路径的社区获得性肺炎诊疗过程质量研究  

Process quality of medical care for inpatients with community acquired pneumonia： a clinical pathway based study

作　　者：白洁[1] 朱洪波 白飞 魏雪峰 夏景林[5] 薛迪[1] 

机构地区：[1]复旦大学公共卫生学院卫生部卫生技术评估重点实验室,上海200032 [2]湖北省卫生和计划生育委员会医政医管处 [3]国家卫生计生委医疗管理服务指导中心 [4]甘肃省卫生和计划生育委员会医政处 [5]复旦大学上海医学院

出　　处：《中华医院管理杂志》2017年第10期770-773,共4页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金（71473047）;美国中华医学会基金（13-153）

摘　　要：目的研究我国公立医院社区获得性肺炎住院诊疗过程与国家临床路径的符合情况。方法在上海市、湖北省、甘肃省的18所公立医院分别随机抽取2014年病案30份，通过病案评阅，分析诊疗过程与国家临床路径要求的符合情况。结果公立医院社区获得性肺炎住院诊疗临床路径的平均符合率为65．1％，入院3天内及时检查和人院病情评估的符合率最低（分别为0．7％和26．6％），初始抗菌使用推荐药物的符合率为48．5％。结论我国公立医院社区获得性肺炎临床路径符合率不高，应重点加强入院检查、病情评估和抗菌治疗的规范性。Objective To study the compliance of medical care at public hospitals in China with corresponding clinical pathway for inpatients of community acquired pneumonia （CAP）. Methods Thirty medical records of inpatients with CAP admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding clinical pathways. Results The average compliance rate of inpatient care of CAP at public hospitals was 65. 1%. The study the lowest compliance rates in both timely examinations/diagnosis and severity assessment within three days after admission （0.7% and 26.6%, respectively）. The compliance rate of reasonable initial antibiotic use was 48.5%. Conclusions The compliance rate of inpatient care of CAP is low in China. Thus admission examinations, patient severity assessment and antibiotic utilization should be enhanced accordingly for their compliance.

关 键 词：临床路径 医疗质量 过程评价 公立医院 社区获得性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]