临床路径在计划性剖宫产中的应用[J]

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1、临床路径在计划性剖宫产屮的应用李丹，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】日的：探讨卫生部试行的临床路径管理在我院计划性剖宫产屮的应用效果。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

2、径组药费下降，但治疗费增加，两组间的药费和治疗费比较，差界均有统计学意义(PV0.05);路径组变界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：AApplicationofClinicalPathwayinScheduledCaesareanSectionLIDan,ZHUYibao,ZHAOFei,etal(JiangxiMaternalandChildCareHospital,Nanch

3、angJiangxi330006,China)Correspondingauthor:LIUHuai【Abstract】Objective:ToevaluatetheeffectofclinicalpathwaytriedoutbytheMinistryofPublicHealthinthescheduledcaesareansection.Methods:185caseswithscheduledcaesareansectionwereselectedclini-calpathway(Pathwaygroup)•96caseswereselectednonclinica

4、lpathwayascontrolgroup.Thetimeofhospitalization,variousmedicalcarecosts,coefficientofvariationandconstituentratioofdifferentparame-ters,andpatient"ssatisfactiondegreeaswellastheircompliedtionsafteroperationwereanalyzedandcom-paredbetweenthetwogroups.ResuIts:Thetimeofhospitalizationinpathw

5、aygroupwasshorterthanthatincontrolgroup.Therewasstatisticaldifferencebetwcenthem(P二0.00).Therewasnostatisticaldifferencebetweenthemaboutmedicalcarecosts(P=0.19)•Inpathwaygroup,theconstituentratioofmedicalcarecostwaschanged.Thedrugcostsweredecreased,butthetreatmentcostswereincreased.Therew

6、assta-tisticaldiffcrenccamongtwogroupsaboutdrugandtreatmentcosts(PV0.05).Comparedtocontrolgroup,thecoefficientofvariationinpathwaygroupwassmallerthancontrolgroup,andthepatient'ssatisfectorydegreewasincreased,buttherewasnoobviouschangesaboutcomplicationsafteroperation.Conclusions:C1inicalp

7、athwayappliedinourhospitalstandardizesmedicaltreatmcntinthescheduledcaesareansection.[Keywords]Clinicalpathway;Scheduledcaesareansection;Medicalcarecost;Coefficientofvariation;Satisfactiondegree为进一步深化医疗改革，2010年初，卫生部在全国各大医院推出了临床路径(clinicalpathway)管理试点工作，旨在探讨一种“规范医疗行为