The Retrospective Analysis Of A Clinical Pathway For Chronic Heart Failure Of Traditional Chinese Medicine

PurposeThis study was carried out literature review and evaluation of Chinese medicine chronic heart failure clinical pathway in Guangdong Provincial Hospital of Traditions Chinese Medicine, for the formation of further industry recognition for the clinical application of Chinese medicine clinics to implement the program and provide evidence-based normative basis.MedthodsThe first, the study was on the basis of previous heart failure TCM treatment in heart center, to the targeted literature survey of heart failure of modern medicine and Chinese medicine treatment. The second, through the same period cohort study compared the clinical pathway before implementation (January 2004-July 2005, the traditional group) and the clinical pathway after implementation(January 2006-July 2007, the path group) in the Heart Department4 in Guangdong Provincial Hospital of Traditions Chinese Medicine- patient treatment of patients with chronic heart failure related to the main case. Evaluation of the main indicators include: 1. Hospitalization and hospital fees related 2. Hospitalization time, 3. Hospitalization costs, 4. Inpatient complications, 5. Readmission rate within six months, 6. Hospital mortality and mortality of one year; 7. Path of implementation, 8. Withdraw from the clinical pathway group of serious variation.ResultThe path group 188 cases, 238 cases of the traditional group, the path group serious variability events in 41 cases, a total of 467 cases. Two groups of patients admitted to hospital on the condition there was no significant difference. With the total cost of inpatient hospitalization time of increased 828.487 yuan / day, the average length of stay from 15.26±9.837 day fell to 12. 87±5. 086 day, which was on a downward trend (P= 0. 096). Average total hospital costs were on a downward trend, from 10735.67 yuan fell to 9104.13 yuan (P = 0.193), which western medicine fees, examination fees had dropped, while costs of proprietary Chinese medicines and herbs had higher costs. Hospital complication rate on the condition there was no significant difference. Overall the rate of readmission within six months, hospital mortality and the one year mortality were on a downward trend. There was over 88.6 percent of the path after the implementation Clinical pathway, and of 17.9 percent of cases there needed to withdraw from the incident variation on the path group.ConclusionAfter implementation of the clinical path, the average length of stay and the patient hospital costs were both on a downward trend. Through the pre-clinical pathway implementation and management, clinical pathway played a role in controlling medical costs, while no significantly impacted the clinical treatment effect. For the next step on the basis of the premise to common medical quality assurance, improve the clinical pathway in the development and management, control medical costs more effective, improve the level of hospital management, strengthening health care, communication between patients,doctor and nurse, improve patient satisfaction, clinical pathway management model to more in-depth and broader direction, and will be recognized after the formation of industry, promote the use of Chinese medicine for clinical treatment programme to provide the necessary evidence-based clinical basis.