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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。
Objective: To observe and analyze the change of medical efficiency in clinical pathway management in our hospital. Methods: The average length of hospital stay and preoperative average length of stay before and after the implementation of clinical pathology for epilepsy, transient ischemic attack (TIA), breast cancer and femoral neck fracture in our hospital were collected and compared. Results: Before and after entering the clinical pathway, the total number of 5 pathways of 4 diseases were 699 cases. (Average) epilepsy, TIA, femoral neck fractures and breast cancer were reduced to varying degrees on average length of stay after the implementation of clinical pathway (all p <0.05), while no significant changes were found in the incidence of intractable epilepsy (P = 0.099). The average length of preoperative stay in breast cancer was shortened (p <0.05) and femoral neck fractures were not significantly different (p = 0.846). Conclusion: Through the implementation of clinical pathology, the average length of stay and preoperative average length of stay of related diseases were optimized to varying degrees. At the same time, changes in the index before and after the clinical pathway help to infer the rationality of the path formulation and whether there is room for optimization, it is worth careful scrutiny.