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目的探讨临床路径管理(CPM)在医疗指标控制中的作用。方法在临床科室组织开展单病种CPM,根据不同病种,将符合入组标准的住院病例,分别设相应的观察组,其中,针对腹股沟疝无张力疝修补术,将未开展CPM且符合入组标准的病例设为对照组(同期对照)。之前相等时间段内既往病例对应病种设置对照组(历史对照)。比较各病种观察组与对照组患者平均住院日、术前住院时间、住院费用、治愈率等医疗相关指标的不同。结果所有病种观察组中平均住院日降低,满意度评分明显增高;绝大部分病种平均术前住院时间、住院费用、住院药费及药收比、并发症发生率降低;面肌痉挛神经微血管减压术治愈率明显提高。结论对病种实施CPM,提高了工作效率和诊疗质量,实现了合理收费,促进了医患沟通,医疗指标得到有效改善。
Objective To explore the role of clinical path management (CPM) in the control of medical indicators. Methods A single-disease CPM was established in the clinical departments. According to the different diseases, the inpatients who met the inclusion criteria were assigned to the corresponding observation group. Among them, the tension-free inguinal hernia repair for inguinal hernia was performed without CPM Group standard cases as the control group (contemporaneous control). Before the same period of time before the corresponding cases set the control group (history control). The differences of medical-related indexes such as average length of stay, preoperative hospitalization time, hospitalization cost and cure rate were compared between observation group and control group. Results The average length of stay in all disease observation groups was decreased and the satisfaction score was significantly increased. The mean preoperative hospital stay, hospitalization expenses, hospitalization expenses and drug income, and the incidence of complications in most diseases were significantly decreased. The hemifacial spasm nerves Microvascular decompression cure rate was significantly improved. Conclusions The implementation of CPM for the disease type improved the work efficiency and the quality of diagnosis and treatment, realized the reasonable charge, promoted the communication between doctors and patients, and effectively improved the medical indicators.