临床路径在计划性剖宫产中的应用.docVIP

临床路径在计划性剖宫产中的应用李 丹，朱义保，赵 菲，万凌玲，郑九生，刘 淮( 江西省妇幼保健院，江西 南昌 330006)【摘要】 目的: 探讨卫生部试行的临床路径管理在我院计划性剖宫产中的应用效果。方法: 选取 185 例已实施临床路径管理的计划性剖宫产孕妇( 路径组) 和 96 例未实施临床路径管理的计划性剖宫产孕妇( 对照组) ，对两组孕妇的住院天数、各种住院费用、各项指标的变异系数和构成比，以及患者的满意度和术后并发症等指标进行综合比较分析。结果: 路径组住院天数比对照组缩短，差异有高度统计学意义( P = 0. 00) ，但住院总费用两组比较，差异无统计学意义( P =0. 19) ; 对于住院总费用的构成变化，路径组药费下降，但治疗费增加，两组间的药费和治疗费比较，差异均有统计学意义( P＜0. 05) ; 路径组变异系数波动总体较对照组小，患者满意度有所提高，但术后并发症率无明显改变。结论: 临床路径应用于我院计划性剖宫产起到了规范医疗行为的作用。【关键词】 临床路径; 计划性剖宫产; 医疗费用; 变异系数; 满意度中图分类号: R719. 8 文献标识码: AApplication of Clinical Pathway in Scheduled Caesarean SectionLI Dan，ZHU Yibao，ZHAO Fei，et al( Jiangxi Maternal and Child Care Hospital，Nanchang Jiangxi 330006，China)Corresponding author: LIU Huai【Abstract】 Objective: To evaluate the effect of clinical pathway tried out by the Ministry of Public Health inthe scheduled caesarean section． Methods: 185 cases with scheduled caesarean section were selected clini-cal pathway ( Pathway group) ． 96 cases were selected non clinical pathway as control group． The time ofhospitalization，various medical care costs，coefficient of variation and constituent ratio of different parame-ters，and patient’s satisfaction degree as well as their complications after operation were analyzed and com-pared between the two groups． Results: The time of hospitalization in pathway group was shorter than that incontrol group． There was statistical difference between them( P = 0. 00) ． There was no statistical differencebetween them about medical care costs( P =0. 19) ． In pathway group，the constituent ratio of medical carecost was changed． The drug costs were decreased，but the treatment costs were increased． There was sta-tistical difference among two groups about drug and treatment costs( P＜0. 05) ． Compared to control group，the coefficient of variation in pathway group was smaller than control group，and the patient’s satisfactorydegree was increased，but there was no obvious changes about complications after operation． Conclusions:Clinical pathway app