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目的探讨临床路径单病种定额支付方式对医疗费用的影响。方法收集2009年至2011年重庆市黔江中心医院胆囊良性病变择期手术、急性单纯性阑尾炎、计划性剖宫产三个单病种临床路径前、后总费用、药品费用、检查费用资料。采用SPSS11.0统计软件,回顾性分析临床路径单病种管理前后各单病种的治疗费用情况。结果实行临床路径单病种管理后,胆囊良性病变择期手术、急性单纯性阑尾炎及计划性剖宫产总费用、药品费用,与临床路径单病种管理前相比,明显下降,差异有显著性(P<0.05);胆囊良性病变择期手术、急性单纯性阑尾炎检查费用略有下降,无显著差异(P>0.05);计划性剖宫产检查费用略有上升,与实行临床路径单病种管理前相比,差异有显著性(P<0.05)。结论临床路径单病种定额支付方式,能降低病种总费用、药品费用等费用及降低医疗成本,遏制医疗费用不合理增长,减少卫生资源浪费。
Objective To explore the impact of the fixed payment method of clinical pathology on medical expenses. Methods The data of total cost, drug cost and examination cost before and after clinical pathology of three single disease of cholecystodelectomy, acute simple appendicitis and planned cesarean section in Qianjiang Central Hospital of Chongqing from 2009 to 2011 were collected. SPSS11.0 statistical software was used to retrospectively analyze the treatment costs of single disease before and after the management of single pathological disease. Results After the implementation of the clinical pathway of single disease management, the total cost of gallbladder benign elective surgery, acute simple appendicitis and planned cesarean section, the cost of drugs, compared with before the pathological single-disease management, significantly decreased, the difference was significant (P <0.05). The costs of elective surgery and acute simple appendicitis in benign gallbladder decreased slightly (P> 0.05); the cost of planned cesarean section increased slightly, which was not related to the management of clinical pathological single disease Before the difference was significant (P <0.05). Conclusion The clinical path of single disease fixed payment, can reduce the total cost of the disease, drug costs and other costs and reduce medical costs, to curb unreasonable growth of medical costs and reduce waste of health resources.