临床路径用于腹腔镜下胆囊切除术单病种质量控制的效果评价  

Evaluation on application of clinical pathway in single-disease quality control of Laparoscopic cholecystectomy

作　　者：林卓辉[1] 谭文明[1] 龚世菊[1] 冯志平[1] 黄健慈 LIN Zhuo-hui;TAN Wen-ming;GONG Shi-ju;FENG Zhi-ping;HUANG Jian-ci

机构地区：[1]江门市中心医院药学部,广东江门529000

出　　处：《中国药物经济学》2018年第10期15-18,共4页China Journal of Pharmaceutical Economics

基　　金：广东省医学科学技术研究基金项目(No.A2017155)

摘　　要：目的分析探讨临床路径用于腹腔镜下胆囊切除术单病种质量控制的住院费用及合理用药的效果。方法将2016年未开展临床路径和2017年已开展临床路径的单病种腹腔镜下胆囊切除术的患者分别设为对照组和观察组,每组随机抽取80份病例,分析基于临床路径的单病种管理在控制住院时间、住院费用、药品费用、手术费用、检查费用、化验费用、药品费用比例和手术费用比例中的作用,同时探讨基于临床路径的单病种管理对围术期抗菌药物合理使用的作用。结果 2017年开展临床路径的单病种质量控制,患者住院时间、药品费用、抗菌药物疗程均较2016年有所下降,差异均有统计学意义(均P<0.05);药品费用比例由42.40%下降至26.60%,差异有统计学意义(P<0.05);住院总费用虽有下降,但差异无统计学意义;检查费用、化验费用持平;手术费用比例由19.51%上升到25.51%,差异有统计学意义(P<0.05)。围术期抗菌药物预防品种选择合理比例由13.75%提高至81.25%,预防用药时机合理比例由32.50%提高至86.25%。结论通过开展基于临床路径的单病种质量控制,可缩短患者的住院时间,有效降低药品费用,促进临床合理用药,提高医疗质量。Objective To investigate the application of clinical pathway in single-disease quality control of Laparoscopic cholecystectomy on hospitalization expenses and rationality usage of drugs.Methods 80 patients records were randomly selected from 2016 and 2017,respectively.The records selected from 2016 as control group had not developed clinical pathway while those selected from 2017 as study group had developed clinical pathway.Hospitalization day,hospitalization expenses,medicine expenses,operation fee,examination fee,laboratory fee,medicine expenses ratio,operation fee ratio and rationality usage of perioperative antibiotics were compared between two group.Results Compared with control group,the hospitalization day,medicine expenses and duration of antibiotics usage in study group were significantly decreased（P〈0.05）;the medicine expenses ratio was significantly decreased from 42.40%to 26.60%（P〈0.05）;the hospitalization expenses had no significantly difference;the examination fee and laboratory fee had no changed;the operation fee ratio was significantly improved from 19.51%to25.51%（P〈0.05）;the rational ratio of utilization of specises selection,timing of administration for prevention had respectively improved from 13.75%to 81.25%and 32.50%to 86.25%.Conclusion The implementation of clinical pathways in single-disease quality control could decrease hospitalization day effectively,save the hospitalization expenses,promote rational drug use and improve the quality of medical service.

关 键 词：临床路径 单病种 腹腔镜下胆囊切除术 合理用药 

分 类 号：R657.4[医药卫生—外科学]