重庆医学2017，Vol.46Issue(20)：2812-2815,2819,5.DOI:10.3969/j.issn.1671-8348.2017.20.025
实行临床路径管理对医生诊疗行为影响的研究
Study on influence of clinical pathway management on physician diagnosis and treatment behaviors
摘要
Abstract
Objective To observe the influence of the clinical pathway management intervention on medical service behaviors.Methods The clinical cases data in a grade A class 3 hospital of Zhangjiakou City,Hebei Province during 2011-2013 were retrospectively analyzed.The influence of implementing the clinical pathway management on the diagnosis results,medical records writing quality,clinical medication,operation,hospitalization time,medical costs,assisted examination items selection were observed and analyzed.Results The admission and discharge diagnosis coincidence rate and preoperative and postoperative diagnostic coincidence rate of 3 diseases entities in the two groups were 100%,the difference had no statistical significance (P>0.05);the medical record grade-A rate in the implementing clinical pathway group was significantly higher than that in the non-implementing clinical pathway group,the medical record grade-B rate was significantly lower than that in the non-implementing clinical pathway group,the difference was statistically significant (P<0.05);the antibacterial drugs cost and drugs proportion in the implementing clinical pathway group were significantly lower than those in the non-implementing clinical pathway group,the medication proportion within the directory in the implementing clinical pathway group was significantly higher than that in the non-implementing clinical pathway group,the difference was statistically significant (P<0.05);the preoperative preparation time in the implementating clinical pathway group was less than that in the non-implementing clinical pathway group,the difference was statistically significant(P<0.05),the grade-A healing rate had no significant difference between the two groups (P>0.05);the average hospitalization time,total costs,drug costs,laboratory fee and examination fee in the implementing clinical pathway group were lower than those in the non-implementing clinical pathway group,the difference was statistically significant (P<0.05);the operation fee,healthy material fee and nursing fee had no statistically significant difference was statistically significant(P<0.05).Conclusion Implementing the clinical pathway can standardize the doctor′s diagnosis and treatment behaviors and makes the medical work to develop to be more favorable for patients.关键词
临床路径/医生诊疗行为/胆结石/胆囊切除术,腹腔镜/慢性鼻-鼻窦炎/糖尿病,2型Key words
clinical pathways/physician diagnosis and treatment behavior/cholelithiasis/cholecystectomy/laparoscopic/chronic rhinosinusitis/diabetes mellitus,type 2分类
医药卫生引用本文复制引用
黄先涛,武雪亮,薛军,汤学勤,潘利民,靖超,席彪..实行临床路径管理对医生诊疗行为影响的研究[J].重庆医学,2017,46(20):2812-2815,2819,5.基金项目
河北省卫生计生委指令性科研项目(ZL20140325). （ZL20140325）
