Analysed Study Of The Influencing Factors In Formulating Clinical Pathway For Patients With Cholecystectomy

Objective: To discuss the influencing factors of clinical pathway for cholecystectomy, and analyse the main factors that affect the costs and days of staying in hospital with cholecystectomy in order to provide corresponding measures and theories in formulating the clinical pathway.Methods: After consulting the information of the 206 operation patients undergoing cholecystectomy from June 2003 to June 2004, treated either by laparoscopic cholecystectomy or open cholecystectomy clinical data of age, sex, diagnosis, preoperative accompanying disease, the amount of transfusion, postoperative complications, hospital stay, hospital charges were respectively analysed by retrospective study. Using multiple regressive analysis, main affecting factors of hospital stay, hospital charges were sifted.Results: Hospital stay is influenced by the accompanying disease, in the time of operation, days of dripping, days of preoperative, days of postoperative respectively with single-variable statistic analysis. Hospital charges is influenced by age, distribution of diagnosis, the accompanying disease, types of operation, in the time of operation,days of dripping, days of preoperative, hospital stay respectively with single-variable statistic analysis. The multiple regressive analysis of influencing hospital stay and charges showed that there were four main factors include accompanying disease, postoperative complications, the time of operation and types of operation affecting hospital stay, among which postoperative complications has the greatest effect (standard partial regressive coefficient = 0.242). four main factors include types of operation, days of transfusion, complications and hospital stay affecting hospital charges, among which the various operations was the most influential (standard partial regressive coefficient = 0.830).Conclusions: It was essential to establish the standard of admittance and exit, intervene and handle the influencing factors early to reduce the occurrence of variance ,such as days of transfusion, in the time of operation, complications in formulating a cholecystectomy clinical pathway. It was better to formulate different clinical paths separately for the various operations of cholecystectomy and for the patients with two types accompanying disease.