| Background:The medical quality management is the core of the hospital and the eternal theme, Is a continuous improvement process. Single disease quality control is the effective measure to reflect and improve medical quality, By mobilizing the hospital, hardware and software work closely with, by simply focus on terminal quality to focus on the transition of the link of the whole process of quality. Acute myocardial infarction is one of eight common diseases emergency door burst, critical illness, but also the kind of quality control of a single disease. Research shows that we will understand and improve the quality of diagnosis and treatment of acute myocardial infarction by the single disease indicators.Z hospital has eight single diseases quality management work, and made significant progress, The number of cases reported and reporting quality are increasing and upgrading. Quality control of acute myocardial infarction is currently studying abroad have made rapid development, though some advanced researchers have made on this theme, there existed some limitations.Objective:(1) To analyze process quality of the acute myocardial infarction in Z hospital;(2) To evaluate the new index for diagnosis and treatment results of influence(the average hospitalization cost, the average expenses for medicine, and diagnosis and treatment of such confinement effect on average);(3) Provide basic data for the study of health administrative departments to improve quality control system in acute myocardial infarction.Methods:From the single diseases quality control database that Z hospital reporting to the Chinese hospital association, picking180cases patients with acute myocardial infarction (ami) as the research sample, using Excel input, to improve the accuracy, with the method of double entry. Statistical analysis using four quadrant diagram Z hospital with acute myocardial infarction, the ratio of the diagnosis and treatment quality and cost; Using multiple linear regression statistical analysis process index for clinical results (average hospitalization costs, the average expenses for medicine and such confinement); Using Logistic regression model analysis of the effect of each process index for diagnosis and treatment.Results:(1)In180patients, male,110, accounting for61.11%, the average age was63.68±13.69years old; Women of70, accounting for38.89%, the average age was62.83±14.54years old;(2) the diagnosis and treatment process in the execution of three indicators of execution on the low side, respectively is "arrived at the hospital after the immediate use of aspirin (have taboos should be paid to clopidogrel to the hospital within30minutes of implementation thrombolysis treatment" and "to the court within90minutes of the implementation of percutaneous coronary intervention (PCI) therapy".(3) in the second half of2013Z hospital medical quality compared with the second half of2012, down11%, than the average level of12.5%; Cost more than in2012,2012yuan more than the citywide average increased by1422yuan.(4) Impact on hospital costs in descending order of priority for the: the PCI treatment>thrombolytic therapy> using beta blockers> use of aspirin;(5) the influence on the drug by arrangement is the most important is:the use of PCI treatment> Thrombolytic therapy> aspirin use> using beta blockers;(6) Impact on length of stay in descending order of priority for the:Thrombolytic therapy> PCI treatment> use aspirin use> betablockers;(7) In terms of impact on clinical results, the use of aspirin, Thrombolytic therapy, PCI treatment, the use of β-blockers P values were0.049,0.041.0.039,0.036,<0.05, That three variables were statistically significant, have significant effects on diagnosis and treatment effect.Conclusion:The basic process of diagnosis and treatment of acute myocardial infarction of Z hospital is in line with National Health and Family Planning Commission "quality control index of single diseases acute myocardial infarction", hospital, hospitalization and discharge when the use of drugs, patients with secondary prevention can be widely implemented, similar indicators were higher than the average of2011in Beijing, the norm in the medical record information reporting, early reperfusion therapy there is further room to improve. |
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