慢性肾脏病3～5期中西医结合临床路径多中心实施的效果研究

发布时间：2018-04-27 03:27

本文选题：慢性肾脏病 + 临床路径　；参考：《中国全科医学》2012年11期

【摘要】：目的探索及评估慢性肾脏病3～5期中西医结合临床路径多中心实施的效益。方法采用非同期历史对照,评估5家医院实施临床路径规范化管理后,患者住院天数、住院费用的改善情况。结果路径组的平均住院天数较回顾性病案组略有缩短,存在中心效应(P=0.000),经校正后平均住院天数间差异无统计学意义(P=0.621)。住院总费用较回顾性病案组稍有升高,不存在中心效应(P=0.126),组间比较差异无统计学意义(P=0.381)。费用明细支出,中药费、西药费、检查费和放射费较回顾性病案组降低,中成药费、治疗费和化验费较回顾性病案组明显升高,其中中药费、放射费、化验费组间比较差异有统计学意义(P0.05)。结论在保证临床路径执行率的情况下,慢性肾脏病3～5期临床路径能缩短住院天数。虽未能降低住院总费用水平,但费用明细支出的改变在一定程度上体现了该路径的实施目的。
[Abstract]:Objective to explore and evaluate the effectiveness of multi-center implementation of integrated traditional Chinese and western medicine in stage 3 of chronic kidney disease. Methods five hospitals were used to evaluate the improvement of hospitalization days and hospitalization expenses after the standardized management of clinical path was carried out in 5 hospitals. Results the average length of hospitalization in the path-group was slightly shorter than that in the retrospect STD group, and there was a central effect of P0. 000. There was no significant difference in the average hospitalization days between the two groups after correction (P 0. 621). The total cost of hospitalization was slightly higher than that of retrospective STD cases, and there was no central effect (P = 0.126), and there was no significant difference between the two groups (P < 0.01). Expenses in detail, Chinese medicine, western medicine, examination and radiation costs were lower than those in the retrospective STD cases group, while the costs of Chinese patent medicine, treatment and testing were significantly higher than those of the retrospective STD cases group, among which the drug and radiation costs were significantly higher than those in the retrospective STD case group. The difference between the two groups was statistically significant (P 0.05). Conclusion under the condition of ensuring the execution rate of clinical pathway, phase 3 clinical pathway of chronic kidney disease can shorten the hospitalization days. Although the total cost level of hospitalization has not been reduced, the change of the detailed expenditure reflects the implementation purpose of the route to some extent.
【作者单位】：广东省中医院肾内科;广州中医药大学博士后科研流动站;
【基金】：国家中医药管理局公益性行业科研专项(200707004)
【分类号】：R692

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