【摘要】 目的探讨导入单病种个案管理系统后急性ST段抬高心肌梗死(STEMI)医疗质量改善与成效。方法选取医院2015年1月至4月STEMI患者36例为导入单病种临床服务项目认证(CCPC)前组,2017年1月至4月STEMI患者51例为导入CCPC后组。结果与导入CCPC前组比较,导入CCPC后组患者到达急诊科至首次心电图接诊时间、至确诊STEMI时间、门-球时间(D2B)、住院时间、D2B90 min达标率、院内急性心肌梗死(AMI)复发率、院内再次经皮冠状动脉介入治疗(PCI)率和病死率差异均有统计学意义(P <0.05),而次均费用差异无统计学意义(P> 0.05)。结论 CCPC-AMI单病种个案管理系统,可显著缩短D2B和住院时间,显著降低院内再次PCI率、院内AMI复发率和病死率,但次均费用改善效果不显著。更多还原

【Abstract】 Objective To investigate the improvement and effect of medical quality in patients with acute ST-segment elevation myocardial infarction(STEMI) after the introduction of the single disease case management system.Methods Totally 36 patients with STEMI from January to April 2015 were selected as the pre-introduction of clinical care program certification(CCPC) group,while 51 patients with STEMI from January to April 2017 were selected as the post-introduction of CCPC group.Results There were significant differences in the terms of the interval time of the patient arrived at the emergency department to the first electrocardiogram, to the confirmed diagnosis as STEMI, door to ballon time(D2B), length of hospital stay, 90-min compliance rate of D2B, recurrence rate of acute myocardial infarction(AMI) in the hospital,re-percutaneous coronary intervention(PCI) rate and fatality rate in the hospital between the post-introduction of CCPC group and the pre-introduction of CCPC group(P < 0.05).However,there was no significant difference in fee per time between the two groups(P > 0.05).Conclusion The introduction of CCPC-AMI single disease case management system can significantly shorten the D2B and the length of hospital stay, significantly reduce re-PCI rate, AMI recurrence rate and fatality rate,but the effect of improving the fees per time is not significant.更多还原