临床路径管理的关键环节与控制策略分析-analysis of key links and control strategies of clinical pathway management.docxVIP

华 华 中 科 技 大 学 硕 士 学 位 论 文 PAGE 4 PAGE 4 1. 4 实施临床路径管理关键环节控制前后患者住院费用影响因素 未实施关键环节控制与实施关键环节控制的患者的药费和药品比一直是影响住 院总费用的主要影响因素，药品的合理使用成为控制患者住院总费用的重要举措。 2. 建议 2. 1 运用PDCA循环模型促进临床路径管理关键环节控制 将PDCA循环应用于临床路径关键环节控制中对于保持临床路径管理在医院长效 开展、促进关键环节控制更加科学化、合理化具有重要意义 2. 2 针对重点关键环节促进临床路径管理持续改进 运用六西格玛管理理论，促进临床路径管理关键环节控制的持续改进就要针对重 点关键环节提出相关策略，做到严格路径设计，确保临床路径文本的实用性；明确诊 断依据，把好临床路径患者准入关；掌握病种选择原则，保证实施效果；提高领导支 持力度，促进临床路径管理的良性循环；及时总结经验，注重结果反馈与应用。 2. 3 加大政府支持力度，促进长效机制形成 国外实践证明，政府政策支持是临床路径管理能否有效开展的重要因素之一。由 于我国临床路径管理现在正处于探索阶段，因此，政府要加强临床路径管理就要在现 有临床路径管理经验的基础上，出台相关制度，确保临床路径管理的法律效力；建立 适合临床路径开展的医疗费用补偿机制和医疗保险支付方式；加大财政投入力度，在 全国范围内建立大规模一体化医院信息系统，促进临床路径管理长效机制的形成。 关键词：临床路径；关键环节；医疗质量；控制策略 Study on Key Links and Control Strategy of Clinical Pathway Management Candidate : Guo Shuyan Supervisor: Tao Hongbing ABSTRACT As a new kind of quality management mode, clinical pathway has great effect in improving the quality of medical treatment, ensuring medical safety and reducing medical costs. Summarized the experience of clinical pathway in foreign country,we found that the clinical pathway management is a comprehensive system. It needs high levels of management techniques, advanced management concept, reasonable allocation of human resources and supporting incentive-restricted mechanisms in the hospital. At present, in the process of implementing clinical pathway,there are a series of problems such as the management concepts of hospital administrators fall behind, the infrastructure and information system of hospital is relatively backward, medical insurance mechanism is not sound, compensation mechanism of medical expenses is not supporting. The internal dynamics and external pressures are lack of clinical pathway management. The development of clinical pathway in China can not reach the expectations and the model of clinical pathway has not been widely used in China. This study intends to explore the key links through the process of clinical pathway management, to analyse the problems and formulate effecti