广西医学2025，Vol.47Issue(3)：428-433,6.DOI:10.11675/j.issn.0253-4304.2025.03.15
本土化临床路径对国家三级公立医院绩效考核单病种管理作用的实证研究
Empirical study on effect of localized clinical pathway on single-disease management in the National Performance Assessment of Tertiary Public Hospitals
摘要
Abstract
Objective To evaluate the management effect of localized clinical pathway on single-disease control indices in the National Performance Assessment of Tertiary Public Hospitals(referred to as National Assessment),so as to provide references for improving single-disease management effect.Methods Patients with cerebral infarction receiving medical treatment in a class Ⅲ level A hospital were selected as the research subjects.Patients in Inpatient Ward A,where localized clinical pathway was implemented,were assigned to experimental group,while those in Inpatient Ward B without localized clinical pathway were served as control group.Propensity score matching(PSM)was used to match the data of patients in both groups,with 162 patients in each group finally included.A difference-in-differences model was applied to assess the management effects of localized clinical pathway on National Assessment single-disease control indices,including hospitalization costs and length of hospital stay,etc.Results After implementing localized clinical pathway,the total hospitalization costs for patients with cerebral infarction receiving medical treatment decreased by 7645.25 yuan,with medical service fees reduced by 4665.26 yuan,medication costs by 2966.11 yuan,and material expenses by 196.26 yuan.Additionally,the length of hospital stay shortened by 4.51 days(P<0.05).Conclusion The adoption of localized clinical pathway for single-disease quality control in the National Assessment can reduce medical service fees,medication costs,and material expenses while shortening length of hospital stays.Public hospitals should refine clinical pathway management systems and accelerate the localization of clinical pathway.关键词
脑梗死/临床路径/单病种/国家三级公立医院绩效考核/本土化/倾向得分匹配/双重差分模型Key words
Cerebral infarction/Clinical pathway/Single-disease/National Performance Assessment of Tertiary Public Hospitals/Localization/Propensity score matching/Difference-in-differences model分类
预防医学引用本文复制引用
陈凤磊,梁冰,朱平华,陈艺飞,蒋敦科,张宏亮,周颖..本土化临床路径对国家三级公立医院绩效考核单病种管理作用的实证研究[J].广西医学,2025,47(3):428-433,6.基金项目
国家卫生健康委医疗质量(循证)管理研究项目(YLZLXZ24K005) （循证）
广西高校人文社科重点研究项目(2022RWB14) （2022RWB14）
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20240504) （Z-A20240504）
广西医科大学第一附属医院自设培育项目(YYZS2022021) （YYZS2022021）
