Applying Of Network Data And Statistical Methods In Studying Clinical Pathway

With the development of medical insurance system, the demand and behavior of hospitalization is changed absolutely, and the competition of medical service market is aggravated. Each hospital pays close attention to the task on how to further advance medical quality and provide low-price-high-quality medical service. Hospital must continuing improve the service quality and efficiency, minimize the resource costing when affords appropriate medical service for patient, and must explore advanced quality control methods or modes in aspect of quality control. The Clinical Pathways came into being in eighties with the above background. It can provide recommended and countermeasure projects for scientific management and clinic decision that the using of statistical and other methods in establishing the Clinical Pathways, the clinical utilization and supporting to Clinical Pathways of network data of Hospital Information System, which have the effects of reducing length of stay, regulating diagnosis and treat behavior, improving the system and integrality of medical service, increasing the satisfaction of patients, and so on. Therefore, study of applying of network data and statistical and other methods in Clinical Pathway has important practical meaning.Study purpose and methods: Probing into the supporting of network data to Clinical Pathway and its clinic using, the applying of statistical and other methods in Clinical Pathway study. Collecting and cleaning the entire network data of medical server about patients,using medical Statistical analysis method, Business Process Reengineering method, systematic review of Evidence-based medicine, combining with expert consultation method and so on, to select the critical paths of diagnosis and treatment of ordinary mono-disease, to eliminate the effect of invalidity factors, and to form respectively the clinical pathways of ordinary mono-disease, which provides methods and practice references to clinic decision-making.Main study processes and results: In aspects of data preparation and ordinary mono-disease selection, the study based on the entire network data of hospitalization patients of certain medium general hospital from 1998 to 2000, and did a lot of dead work of data. Checking, cleaning, abstraction and pretreatment all of the data, deleting the cases which the main medical information was depletion, which had special coding and which was unconformity logic, and so on. After pretreatment, there were all of 30,340 cases, among which there were 10,361 cases of operation patients and 19,979 cases of none-operation patients.In order to reach rather consistency, the study strictness controlled the disease categories and types, formed the ordinary mono-disease categories of operation and none-operation patients according to the six digits coding of ICD-9-CM-3 and ICD-9, and sorted by variance of each category. The study of clinical pathway requires the case sample of selected disease or treatment procedure is great, meanwhile, its variance must minimize. Consequently, the appendectomy (47.0001) and cholecystectomy (51.2201) of operation diseases were selected. About none-operation diseases, due to the relative greater variance of digestive system diseases, anti-H. pylori infection was selected to carry out the clinical pathway analysis which was the specific diagnosis and treatment problem of chronicity gastritis (535.102), peptic ulcer (duodenal bulb ulcer (532.902) and gastrelcoma (531.901)).Preliminary analysis was carried out on medicine circumstance of hospitalization operation patients with minor variance and goodconsistency. Cleaning and pretreatment of data was done once again to finally ensure the study data set. Then detailed statistics method analysis was carried out on hospitalization expenditure, medicine service condition, examine and inspection item condition, condition and influence factors of length of stay and insignificance length of stay, etc. The whole doctor's advices were analyzed in detail, and the reasonable average length of stay and t...