基于临床路径的急性左心功能衰竭诊疗过程质量研究  

Study on process quality of medical care in with acute left ventricular failure according to national clinical pathway

作　　者：魏雪峰 白洁[2] 汤慧芹 白飞 朱洪波 薛迪[2] WEI Xuefeng;BAI Jie;TANG Huiqin;BAI Fei;ZHU Hongbo;XUE Di(Health and Family Planning Commission of Gansu Province,No.220,Baiyin Road,Lanzhou,730030,Gansu Province,PRC)

机构地区：[1]甘肃省卫生和计划生育委员会,兰州市730030 [2]复旦大学公共卫生学院、卫生部卫生技术评估重点实验室,上海市200032 [3]湖北省卫生和计划生育委员会,湖北省武汉市430079 [4]国家卫生计生委医疗管理服务指导中心,北京市100044

出　　处：《中国医院》2018年第4期22-24,共3页Chinese Hospitals

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

摘　　要：目的:研究国内公立医院急性左心功能衰竭住院诊疗与国家临床路径的符合性。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性。结果:国内公立医院住院患者急性左心衰临床路径的平均符合率为68.0%,入院60分钟内利尿剂和钾剂的使用符合率以及住院首查和出院复查左心功能的符合率低(分别为32.9%、40.6%和41.6%)。结论:国内公立医院应提高对住院急性左心衰患者左心功能检查及合理使用利尿剂和钾剂的重要性认知,以规范医疗服务。Objective:To study on the compliance of medical care with corresponding national clinical pathway in the inpatients with acute left ventricular failure(ALVF)in public hospitals of China.Methods:Thirty medical records of the inpatients with CAP admitted in 2014 were randomly sampled from each of 18 public hospitals in Shanghai,Hubei Province and Gansu Province and were assessed on the compliance with corresponding national clinical pathway.Results:In inpatient care of ALVF in public hospitals,the average compliance rate of ALVF was 68.0%.The compliance rates of timely use of diuretics and potassium agents within 60 minutes after admission,assessment and reassessment of left ventricular function were low(32.9%,40.6%and 41.6%,respectively).Conclusions:The importance of assessment of left ventricular function and of appropriate use of diuretics and potassium agents for the inpatients with ALVF should be recognized in public hospitals of China to improve medical care.

关 键 词：临床路径 医疗质量 过程评价 公立医院 急性左心功能衰竭 

分 类 号：R197.323[医药卫生—卫生事业管理]