Analysis And Effect Evaluation Of Clinical Path Of Primary Hospital

Objective: Basic situation through the county-level hospitals and clinical pathway to carry out nearly three years of study,statistics and analysis into the diameter rate and mutation rate,completion rate,as well as to the implementation of clinical pathway of its three diseases before and after hospitalization days and total hospitalization expenses,drug expenses such as index,evaluation of the county-level hospitals clinical path implementation status and effect,find out the influence factors on the implementation of the county hospital clinical application path.Methods: Using the current situation study method,the number of clinical paths,the diameter rate,the rate of mutation rate and the completion rate of the clinical path of the sample hospital were described.Historical cohort study methods,the choice is the implementation of clinical pathway management of bronchial pneumonia,inguinal hernia,planned cesarean section and so on three kinds of patients as path group,choose for the same disease in patients who were not the implementation of clinical pathway as the control group,the hospitalization days and total hospitalization expenses,drug expenses such as indicators for statistical analysis.The mean number of quantitative data is described,and the statistical inference is based on the independent sample t-test and the non-parametric test is adopted when the variance is different.The method of qualitative data is used for statistical description,and it is assumed that the test or Fisher precise probability method is tested.Using software SPSS19.0 for statistical analysis,the test level of bilateral test was α=0.05.Results: The studies show that from January 1,2014 to December 31,2016,sample hospital developed 94 kinds of clinical pathway,actually carried out 69 diseases,three years to carry out the clinical path 8978 cases,among which 2014 were carried out in 2014,in 1524 cases,2015,2016 in 7391.Between various departments and various diseases "into" diameter rate and mutation rate,completion rate were similar,all kinds of diameter rate achieves 50%,completion rate above 70%,also accord with the requirement of health and family planning commission,the mutation rate is generally on the high side,far less than health development planning commission on clinical path variation rate is less than 15%.There was no statistically significant difference in age and gender between the selected path group and the control group(P>0.05),and the two groups were comparable.Bronchial pneumonia,inguinal hernia,three diseases such as path planning cesarean delivery group of patients compared with control group,the average hospitalization day decreases,the length of the total cost reduced to some extent,the average expenses for medicine control group were slightly lower,the differences were statistically significant(P < 0.05).Conclusion: County-level hospitals to carry out the clinical pathway of the number of cases increased year by year,number of diseases,improvement management,from the point of hospital stay,the implementation of clinical pathway management reduces the average such confinement of patients,improve the efficiency of the hospital beds and utilization.But at the same time,in the implementation of the sample hospitals also has some problems,such as mutation rate is generally on the high side,shows that hospital in clinical pathway implementation management lack of strength,how to reduce the variation rate,increase effective completion is the present sample hospitals have been the focus of the implementation of clinical pathway management.