【摘要】 目的探讨临床路径在儿科单病种管理中的应用效果。方法选择2011年7月1日至2013年6月30日在深圳市罗湖区妇幼保健院儿科住院治疗并实施临床路径管理的轮状病毒肠炎、新生儿ABO溶血症患儿190例为研究组,2009年7月1日至2011年6月30日期间入住该院未实施临床路径的相同病种患儿130例为对照组,对比分析两组患儿的住院天数、住院总费用及各项分费用及其变异系数、药占比等效果评价指标。结果实施临床路径的研究组患儿平均住院天数较对照组减少,组间差异有统计学意义(P<0.05)。研究组患儿平均住院费用均有不同程度的下降;其中除了轮状病毒肠炎患儿化验费研究组高于对照组(P<0.05),两病种的其它项目费用如床位费、诊疗费、药品费等,研究组较对照组均有明显降低,组间差异均有统计学意义(均P<0.05)。两病种药占比研究组显著低于对照组,差异均有统计学意义(均P<0.05)。对照组住院天数、住院总费用及各分项费用各相应参数的变异程度均不同程度地大于研究组。结论临床路径管理在儿科单病种管理的应用,可缩短住院时间,总费用及各分项费用均得到不同程度的控制,并规范了诊疗、护理活动,减少诊疗活动中的随意性与过度医疗的发生。更多还原

【Abstract】 Objective To explore the application of clinical pathway in the management of pediatric single disease.Methods A total of 190inpatients who were diagnosed as having rotavirus enteritis or neonatal ABO hemolytic disease and treated via the clinical pathway were selected as the study group from the Department of Pediatrics,Luohu Maternal and Child Health Care Hospital from July 1,2011to June 30,2013.Another 130inpatients with same diseases and comparable features(from July 1,2009to June 30,2011)served as control group before implementation of clinical pathway.The indicators were compared between the two groups,including the length of hospital stay,hospitalization costs,costs of each item,coefficient of variation and drug proportion.Results The length of hospital day was significantly decreased in the study group than in the control group(P<0.05).The average total costs in the study group had different degrees of decline,as well as the costs of each items such as bed charges,medical costs,pharmaceutical costs(P<0.05).Drug proportion in the study group was lower than in the control group(P<0.05).But lab-test costs of inpatients with rotavirus enteritis were higher in the study group than in the control group(P<0.05).The variation coefficient of the length of hospital stay,total costs,costs of each item was greater in the control group than in the study group(P<0.05).Conclusion Implementation of clinical pathway management in the pediatric single disease can shorten the length of hospital stay and decrease hospitalization costs including the total cost and costs of each item.It can regulate the medical care activities and decrease the arbitrary and excessive medications in clinical practice.更多还原