先天性心脏病微创治疗临床路径评价体系构建  

Construction of clinical pathway evaluation system for minimally invasive treatment of congenital heart disease

作　　者：李翔[1] 薛超[1] 张溧昀 江丽清 朱翰朝 翟蒙恩 梁宏亮[1] 俞世强[1] 刘金成[1] 段维勋[1] LI Xiang;XUE Chao;ZHANG Liyun;JIANG Liqing;ZHU Hanzhao;ZHAI Meng′en;LIANG Hongliang;YU Shiqiang;LIU Jincheng;DUAN Weixun(Department of Cardiovascular Surgery,Xijing Hospital of Air Force Military Medical University of Chinese People′s Liberation Army,Xi′an,Shaanxi,710032)

机构地区：[1]中国人民解放军空军军医大学西京医院心血管外科,陕西西安710032

出　　处：《实用临床医药杂志》2022年第16期56-60,65,共6页Journal of Clinical Medicine in Practice

基　　金：国家重点研发计划重大慢性非传染性疾病防控研究(2016YFC1301900);国家自然科学基金面上项目(81870218,81970213,82070503);国家自然科学基金青年项目(82000373);陕西省创新人才推进计划(2017KJXX-05)。

摘　　要：目的 构建先天性心脏病微创治疗临床路径评价体系。方法 对2001—2021年Cochrane Library、PubMed数据库和中国知网(CNKI)数据库收录的先天性心脏病微创治疗评价研究相关文献进行量化分析,描述评价指标引用情况,结合先天性心脏病微创治疗临床路径相关诊疗指南,融入专家论证共识,构建评价指标体系。结果 数据库共检出332篇有效文献,包括外文文献44篇、中文文献288篇;评价指标分析得到业务指标32项,卫生经济学指标7项。将分析结果结合微创治疗临床路径诊疗指南以及专家论证共识,最终形成了由5项一级指标(医疗效率指标、治疗相关指标、医疗质量指标、医疗费用指标、医疗服务指标)和31项二级指标组成的先天性心脏病微创治疗临床路径评价体系。结论 本研究构建的先天性心脏病微创治疗临床路径评价指标体系后续可帮助各心脏中心将临床路径实施情况进行可视化对比,找出差异问题,从而提高救治效率,改善治疗效果,减少住院费用,减轻患者家庭和社会负担。Objective To construct clinical pathway evaluation system for minimally invasive treatment of congenital heart disease.Methods Literatures on evaluation of minimally invasive treatment of congenital heart disease in Cochrane Library, PubMed and Chinese National Knowledge Infrastructure(CNKI) from 2001 to 2021 were quantitatively analyzed, and the citation of evaluation indexes was described.The evaluation index system was constructed based on relevant guidelines of clinical pathway of minimally invasive treatment for congenital heart disease and the consensus of experts.Results A total of 332 valid articles were retrieved, including 44 in English and 288 in Chinese.From the results of evaluation index analysis, 32 business indicators and 7 health economics indicators were obtained.According to analysis results, clinical pathway guidelines of diagnosis and treatment for minimally invasive treatment and expert consensus, a quality evaluation index system of clinical pathway for minimally invasive treatment of congenital heart disease was formed, including 5 first-level indexes(medical efficiency index, treatment-related index, medical quality index, medical cost index, medical service index) and 31 second-level indexes.Conclusion The evaluation index system of clinical pathway for minimally invasive treatment of congenital heart disease constructed in this study can help heart centers to visually compare the implementation of clinical pathways and find out differences, thereby improving treatment efficiency and treatment effectiveness, reducing hospitalization costs, and relieving family and social burden.

关 键 词：先天性心脏病 微创治疗 临床路径 评价体系 医疗质量 医疗费用 

分 类 号：R605[医药卫生—外科学] R541.1[医药卫生—临床医学]