临床路径信息管理平台的应用效果评价  

Research on the application effect assessment of information management platform of clinical pathway

作　　者：袁骏毅[1,2] 潘常青 范小红[3] 陈璨[1] YUAN Jun-yi;PAN Chang-qing;FAN Xiao-hong(Information Center,Shanghai Chest Hospital(Shanghai Chest Hospital,Shanghai Jiao Tong University),Shanghai 200030,China;不详)

机构地区：[1]上海市胸科医院(上海交通大学附属胸科医院)信息中心,上海200030 [2]上海交通大学中国医院发展研究院研究所,上海200020 [3]上海市胸科医院(上海交通大学附属胸科医院)院办,上海200030

出　　处：《中国医学装备》2020年第8期140-143,共4页China Medical Equipment

基　　金：上海交通大学中国医院发展研究院科研课题(CHDI-2019-B-18)“面向服务质量评估的临床病历无纸化应用研究”;上海交通大学转化医学交叉研究基金(ZH2018ZDA28)“基于大数据的胸部肿瘤专病数据库的建设及诊疗模型的构建”。

摘　　要：目的:构建临床路径信息管理平台,探讨其规范病种治疗的应用效果。方法:基于微软.Net浏览器与服务器(B/S)三层架构,采用SQLSERVER2015数据库,结合医院信息系统(HIS)和电子病历(EMR)系统,构建临床路径信息管理平台。选取医院收治的不稳定性心绞痛、冠状动脉粥样硬化、支气管肺癌和食管癌化疗4个病种的120例病例患者,按照收治时间不同分组,将2018年6-12月收治的60例患者纳入对照组,采用常规临床路径治疗;2019年2-7月收治的60例患者纳入观察组,采用临床路径信息管理平台治疗。采用医院自定的调查问卷,对比分析两组患者的治疗满意度、住院时间、抗菌药物使用天数和医疗费用。结果:观察组患者对4个病种的治疗满意度评分均高于对照组,其差异有统计学意义(t=2.87,t=2.75,t=3.41,t=3.30;P<0.05),4个病种患者住院天数均低于对照组,差异有统计学意义(t=-3.22,t=-3.38,t=-2.94,t=-3.76;P<0.05);观察组中的不稳定性心绞痛、冠状动脉粥样硬化和支气管肺癌患者的抗菌药物使用天数均低于对照组,差异有统计学意义(t=-4.94,t=-3.39,t=-3.05;P<0.05);观察组4个病种患者的医疗费用低于对照组,差异有统计学意义(t=-2.82,t=-3.82,t=-3.04,t=-4.37;P<0.05)。结论:临床路径信息管理平台能加强对病种的诊疗管理,避免随意的治疗过程,提高医护人员工作效率和医院资源利用率。Objective: To construct information management platform of the clinical pathway so as to explore the application effect of the platform in standardizing disease treatment. Methods: Based on the three-tier architecture of Microsoft.NET browser and Server(B/S), the information management platform of clinical path was built by using SQLSERVER2015 database software and combining with hospital information system(HIS) and electronic medical record(EMR) system. A total of 120 patients with unstable angina pectoris, coronary atherosclerosis, bronchial lung cancer and esophageal cancer treated who underwent chemotherapy were selected and were divided into different group according to different time when they admitted to hospital, with 60 patients in each group. 60 patients who admitted to hospital during the period of June and December of 2018 were divided into control group which adopted routine clinical pathway for treatment, and 60 patients who admitted to hospital during the period of February and July of 2019 were divided into observation group which adopted information management platform of clinical pathway for treatment. And the patients of two groups contained above 4 kinds of diseases. The self-determined questionnaire of hospital was adopted to compare and analyze the treatment satisfaction, length of stay, the number of days of using antibiotics and medical expenses of patients of two groups. Results: The satisfaction scores of observation group for four diseases were significantly higher than those of control group(t=2.87, t=2.75, t=3.41, t=3.30, P<0.05), respectively. The hospitalization days of the four diseases of observation group were significantly lower than those of control group(t=-3.22, t=-3.38, t=-2.94, t=-3.76, P<0.05), respectively. The number of days of using antimicrobial of unstable angina, coronary atherosclerosis and bronchial lung cancer of observation group were significantly lower than those of control group(t=-4.94, t=-3.39, t=-3.05, P<0.05), respectively. The medical expenses of the four

关 键 词：临床路径 信息管理平台 医疗质量 诊疗规范 

分 类 号：R197.323[医药卫生—卫生事业管理]