相关病种实施临床路径前后的医疗效率分析

目的：观察我院相关病种实施临床路径管理的医疗效率变化并作分析。方法：收集我院癫痫、短暂性脑缺血发作（TIA）、乳腺癌和股骨颈骨折4个病种实施临床路径前后共15个月的平均住院日和术前平均住院日资料并作对比。结果：进入临床路径前后4种疾病5个病种路径总的调查病例数均为699例。（普通）癫痫、TIA、股骨颈骨折和乳腺癌在实施临床路径后平均住院日均有不同程度缩短（p均〈0．05），而难治性癫痫路径前后无显著变化（P=0．099）。乳腺癌术前平均住院日在实施临床路径后缩短（P〈0，05），股骨颈骨折则无明显变化（P=0．846）。结论：通过实施临床路径，相关病种的平均住院日和术前平均住院日有不同程度优化。同时，临床路径前后指标的变化有助于推断路径制订的合理性和是否具有优化的空间，值得仔细推敲。

Medical efficiency analysis of some disease before and after implementing clinical pathway

Objective: To observe and analyze the medical efficiency of certain diseases in the clinical pathway management.Methods: Average length of stay and preoperative average length of stay of clinical pathway management disease,namely epilepsy,transient ischemic attack(TIA),breast and femoral neck fracture in 15 months before and after the clinical pathway management was analyzed and contrasted.Results: 699 cases from the four diseases,5 clinical pathways’ total average length of stay after implementing clinical pathway have shortened in different degrees(p < 0.05),however,the index of intractable epilepsy did not changes before and after clinical pathway management(p=0.099).Preoperative average length of stay of breast cancer after the clinical pathway shortened(p < 0.05),but femoral neck fracture did not change(p = 0.846).Conclusions: Average length of stay and preoperative average length of stay of clinical pathway managed diseases have been shortened in different degree after implementing clinical pathway.And index changed can help evaluating the rationality of clinical pathway and whether it has the space for further optimization.