基于医院数据库的临床路径在脑梗死患者中的应用效果评价:一项真实世界研究  

Evaluation of the application of Clinical Pathways in therapy of Cerebral Infarction Patients in China Using the Hospital Database: a Real-world Study

作　　者：王斌[1,4] 忻凌 陈迪[3] 周洪伟[1,4] 史华新[4] 谢琪[4] Wang Bin;Xin Ling;Chen Di;Zhou Hongwei;Shi Huaxin;Xie Qi(Institute of Basic Research in Clinical Evaluation,China Academy of Chinese Medical Sciences,Beijing 100700,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Medical Insurance Office,China Academy of Chinese Medical Sciences Guang'anmeng Hospital,Beijing 100053,China;TCM data center,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]安徽医科大学第一附属医院,合肥230022 [3]中国中医科学院广安门医院,北京100053 [4]中国中医科学院中医药数据中心,北京100700

出　　处：《世界科学技术-中医药现代化》2020年第11期3972-3976,共5页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家科学技术部重点研发项目(2017YFC1703505):多源异构中医科学数据汇交系统的研发,负责人:王斌。

摘　　要：背景通过一项真实的研究来评估临床路径(CP)在脑梗死患者治疗中的应用,并与普通医疗进行比较。通过评估脑梗死患者的住院时间和住院费用来评估临床路径应用的效益。方法数据来源于我院数据库。我们登记所有接受中风治疗的患者(国际疾病分类,第10版)。ed.,2015年6月1日至2016年5月31日期间的临床修改[ICD-10-CM]程序I63.90)。本次评估的标准包括平均服务水平和费用(住院、药物、实验室和放射科)。进行学生t检验和非参数Wilcoxon秩和检验,统计学意义设为0.05。结果以平均值±SE表示。结果:2014年6月1日至2016年5月31日,我院共诊治脑梗死患者1533例。住院人数比上年增加7.66%,由444人增至478人。实施临床路径后平均住院时间由16.70天缩短到15.30天,差异有统计学意义(P<0.05)。住院费用从2326.21美元降至2282.90美元,但两者之间无显著差异(P=0.15)。结论临床路径的应用可显著降低脑梗死患者的住院床日,但医院费用无明显变化。Background A real-world study was performed to evaluate the application of clinical pathways(CP) in treatment of cerebral infarction patients compared with normal medical care. The benefit of clinical pathways application was evaluated by assessing the length of in-hospital stay(LOS)and hospitalization costs in treatment of cerebral infarction patients. Methods Data were derived from the first affiliated hospital of Anhui University of Chinese Medicine HIS database. We enrolled all patients who underwent stroke treatment(International Classification of Diseases,10 th rev. ed.,Clinical Modification[ICD-10-CM]procedure I63.90)between June 1,2015 and May 31,2016. The criteria within this evaluation included the average LOS and costs(hospitalization,drugs,laboratory and radiology). Student’s t-test and nonparametric Wilcoxons rank-sum test were performed and statistical significance was set as 0.05. Results were presented as mean ±SE. Results Between June 1,2014 and May 31,2016,1533 patients with cerebral infarction were diagnosed and treated in the hospital. The number of hospitalizations was 7.66% more than the previous year,increased from 444 patients to478. The average length of hospital stay was decreased from 16.70 days to 15.30 days after the implementation of clinical pathways with a statistical difference(P < 0.05). The hospital costs were decreased from $2326.21 to$2282.90,but there was no significant difference between them(P = 0.15). Conclusion The application of clinical pathways can significantly reduce LOS of cerebral infarction patients. However,the hospital costs were not affected by the use of clinical pathways.

关 键 词：脑梗死 临床路径 真实世界研究 

分 类 号：R242[医药卫生—中医临床基础]