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目的分析脑梗死病种实施临床路径前后医疗费用结构变化,评价临床路径实施效果,为医院在后期扩大临床路径方病种面提供可参考的依据。方法从新疆某三级综合医院病案HIS信息系统收集2014年3月-2016年2月脑梗死住院患者费用信息1258例,采用χ~2检验、t检验、非参数检验对数据进行分析。结果脑梗死实行临床路径前后住院费用有显著性差异(Z=-7.375,P<0.05),实施临床路径后脑梗死患者的住院费用有所下降,由非CP组的8061.19元下降至7091.12元,下降了12.03%;实施临床路径前后的药品费用、检查费用均有显著性差异(P<0.05),且实施临床路径后药品费用有明显的下降,相比非CP组,CP组的药品费下降了19.03%。结论实施临床路径是控制医疗费用增长的有效手段,缩短住院天数和控制药费是临床路径合理化应用的关键,临床路径是规范医师医疗行为的重要管理方式。
Objective To analyze the structural changes of medical costs before and after the implementation of clinical pathology in patients with cerebral infarction and to evaluate the effect of clinical pathology so as to provide a reference for the hospital to expand the clinical path of the disease in later stage. Methods A total of 1258 inpatients with cerebral infarction from March 2014 to February 2016 were collected from the HIS information system of a tertiary general hospital in Xinjiang. The data were analyzed using χ ~ 2 test, t test and nonparametric test. Results There was a significant difference in hospitalization costs before and after the clinical pathway was achieved in cerebral infarction (Z = -7.375, P <0.05). The cost of hospitalization for patients with cerebral infarction after clinical pathway decreased from 8061.19 yuan in non-CP group to 7091.12 yuan, decreased (P <0.05), and the cost of drugs decreased significantly after the implementation of clinical pathway. Compared with non-CP group, the cost of medicine in CP group decreased 19.03%. Conclusion The implementation of clinical pathway is an effective way to control the growth of medical expenses. Shortening the length of hospital stay and controlling the cost of medication are the keys to the rational application of clinical pathway. Clinical pathway is an important management mode to standardize the medical behavior of doctors.