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[目的]探讨临床路径管理在控制乳腺癌患者住院费用及住院天数等方面的效果。[方法]采用回顾性比较临床路径实施前后乳腺癌住院患者的相关情况,主要评价指标包括住院费用、住院天数、医疗质量等。[结果]两组患者的治疗效果、住院病死率、临床与病理诊断符合率、入院与出院诊断符合率之间差异无统计学意义(P>0.05),而临床路径组患者的住院并发症发生率明显低于对照组(8.4%vs 14.7%,χ2=4.768,P=0.009)。临床路径组的平均住院总费用、药费、治疗费、材料费均少于对照组;临床路径组平均住院总天数和术后住院天数均少于对照组(P<0.05)。临床路径组乳腺癌患者住院费用构成前3位依次为药费(57.2%)、检查费(17.8%)和手术费(9.1%),共占住院总费用的82.7%;对照组患者住院费用构成前3位依次为药费(58.7%)、治疗费(15.0%)和手术费(8.7%),共占住院总费用的82.4%。[结论]乳腺癌临床路径管理可以缩短平均住院日、降低住院费用和提高诊疗质量,值得进一步推广。
[Objective] To explore the effect of clinical path management in controlling hospitalization costs and days of hospitalization for breast cancer patients. [Methods] The retrospective comparison of clinical pathology before and after the implementation of breast cancer hospitalized patients, the main evaluation indicators include hospitalization costs, hospitalization days, medical quality and so on. [Results] There was no significant difference between the two groups in the treatment effect, in-hospital mortality rate, coincidence rate of clinical and pathological diagnosis, coincidence rate of admission and discharge diagnosis (P> 0.05), while the clinical pathological group of patients with hospital complications The rate was significantly lower than that of the control group (8.4% vs 14.7%, χ2 = 4.768, P = 0.009). The mean total cost of hospitalization, medicine, treatment and materials in the clinical pathway group were less than those in the control group. The average length of hospital stay and hospital stay in the clinical pathway group were less than those in the control group (P <0.05). The cost of hospitalization for breast cancer patients in the clinical pathway group was 57.2% in the first place, 17.8% in the examination and 9.1% in the operation, accounting for 82.7% of the total cost of hospitalization. The top three were medicine (58.7%), treatment (15.0%) and surgery (8.7%), accounting for 82.4% of the total cost of hospitalization. [Conclusion] The clinical pathway management of breast cancer can shorten the average length of stay, reduce hospitalization costs and improve the quality of diagnosis and treatment, which deserves further promotion.