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目的评价实施脑梗死临床路径的临床效果。方法收集河北某三级综合医院2013年-2016年脑梗死住院患者信息655例(临床路径组)和704例(非临床路径组),观察实施临床路径管理对临床诊断、病案书写质量、临床用药、住院时间、医疗费用、辅助检查项目选择、患者满意度的影响。结果临床路径组患者出院病案甲级率为96.03%明显高于非临床路径组85.94%;乙级率为3.97%明显低于非临床路径组14.06%;临床路径组药占比为35.66%,明显低于非临床路径组的42.18%;目录内用药比例为96.81%,明显高于非临床路径组的87.20%;临床路径组平均住院天数为13.82±4.29明显低于非临床路径组17.07±5.04;临床路径组总费用、药费、化验费、检查费均明显低于非临床路径组;临床路径组患者对医护工作的满意度为92.37%,优于非临床路径组的85.51%,以上比较P<0.05,均差异有统计学意义。结论对脑梗死实施临床路径能够合理规范医疗行为,保障医疗安全,提高患者满意度。
Objective To evaluate the clinical effect of clinical pathology in the implementation of cerebral infarction. Methods A total of 655 patients (clinical pathway group) and 704 patients (non-clinical pathway group) were collected from a tertiary general hospital in Hebei province from 2013 to 2016. The clinical pathology was evaluated for clinical diagnosis, quality of medical record writing, clinical medication , Length of stay, cost of medical care, choice of laboratory examinations, and patient satisfaction. Results In the clinical pathway group, the discharge rate was 96.03%, significantly higher than that of the non-clinical pathway group (85.94%), the B rate was 3.97%, significantly lower than that of the non-clinical pathway group (14.06%), and the clinical pathway group accounted for 35.66% Less than 42.18% in the non-clinical pathway group; the drug use ratio in the directory was 96.81%, significantly higher than 87.20% of the non-clinical pathway group; the average length of stay in the clinical pathway group was 13.82 ± 4.29 significantly lower than the non-clinical pathway group 17.07 ± 5.04; Clinical pathway group total cost, drug costs, laboratory costs, examination fees were significantly lower than the non-clinical pathway group; clinical pathological group satisfaction with medical care work was 92.37%, better than non-clinical pathway group 85.51%, the above comparison P <0.05, the differences were statistically significant. Conclusions The implementation of clinical pathways for cerebral infarction can regulate medical behaviors reasonably, ensure medical safety and improve patient satisfaction.