摘要
目的探讨老年性白内障患者实施临床路径精细化管理对单病种费用的控制。方法某院2014年7月-2016年1月单眼超声乳化联合人工晶体植入术的老年性白内障的全部患者600例,采用历史对照组方法,对老年性白内障临床路径实施前、实施后、单病种付费后进行比较,比较患者的平均住院天数、平均住院费用、患者满意度、并发症的发生率等手术评价指标,住院费用主要构成变化,医疗机构实际补偿比例的变化。结果临床路径实施前,老年性白内障患者的平均住院天数、平均住院费用、患者满意度、并发症的发生率分别是7.75±0.72天、6764.60±92.69元、90.05%、4.98%;临床路径实施后,分别是6.35±0.67天、5865.60±50.17元、95.00%、4.00%;单病种付费后,分别是3.80±1.79天、5429.60±82.26元、97.00%、4.00%;平均住院天数、平均住院费用、患者满意度的比较,差异有统计学意义,P<0.05;并发症发生率无明显差异,P>0.05。住院费用中的西药费、材料费、其他费显著下降,差异有统计学意义,P<0.05;而治疗费显著增长,差异有统计学意义,P<0.05。医疗机构实际补偿比例明显提高,差异有统计学意义,P<0.05。结论采用临床路径单病种定额支付方式能够有效的节约卫生资源,提升医疗服务质量,减轻患者的经济负担,在一定程度上缓解医患之间的矛盾。
Objective To investigate the application effects of clinical pathways delicacy management on the single disease cost control of senile cataract patients. Methods According to historical control group method, we analyzed the results in clinical pathways of senile cataract before and after the application of single disease payment, compared the average hospitalization days of patients, the average hospitalization cost, patient satisfaction, the incidence of complications such as main components evaluation indicators, hospital operation cost change, the change of the actual compensation rate of medical institutions. Results Before the implementation of clinical pathway, the average hospitalization days of senile cataract patients, the average hospitalization cost, patient satisfaction, the incidence of complications were 7.75 ± 0. 72 days, respectively, 90. 05%, 4. 98%, 6764.60 ± 92.69 yuan. Since the implementation of clinical pathway were 6.35 ± 0. 67 days, 5865.60 ± 50. 17 yuan, 95.00%, 4. 00%; After the single macro-reforms, respectively were 3.80 ± 1.79 days, 5429. 60 ± 82. 26 yuan, 97.00%, 4. 00 %.The average hospitalization days, average hospitalization expenses, the comparison of patient satisfaction, the differences were statistically significant （P〈0. 05）, no difference between the incidence of complications （P〉 0. 05）. Medicine cost of hospitalization expenses, a significant reduction in the cost of raw materials, and other costs, the differences were statistically significant （P〈0. 05）, while treatment significantly increased, the difference was statistically significant （P〈0.05）. Medical institutions actual compensation ratio increased significantly, the difference was statistically significant （P〈0. 05）. Conclusions The implementation of clinical pathways could save health resources effectively, improve the quality of medical service, decrease the burden of the patients and alleviate the contradiction between doctors and patients to some extent.
出处
《中国病案》
2017年第5期39-42,共4页
Chinese Medical Record
关键词
老年性白内障
临床路径
单病种付费
Senile cataract
Clinical pathways
Single disease payment
