Study Of Clinical Pathway In Improving Medical Quality Management

Medical cost has increased rapidly recently and it is the same question for all governments in the world.As presumed,if there is no effective methods to control it,the cost of health will increase 10 percent each year and finance of country cannot afford it for long time. A new standard management modes which could not only maintain medical quality but also reduce medical cost and save medical source should be explored.And this management modes will be paid more attention by medical field.Clinical pathway (Cp) is such new hospital management models.ObjectiveAs a new kind of management model,Cp was introduced to some provinces such as Beijing in China. But it was only used in single disease and specifically focused on surgery diseases. Its effects could not be observed constantly.Daqing Oilfield General Hospital is the first hospital that actualizes Cp in hospital management for 4years in Heilongjiang Province.In order to make sure that the affection of Cp on quality of hospital management,we began the study .We studied several subjects as well as constant study.MethodsThe experiences of Cp research and exertion that came from inside and outside country were used in our study.We chose four common diseases in Daqing Oilfield General Hospital.They were bronchia pneumonia of pediatrics,Uterine leiomyoma of gynecology,acute gastritis of internal medicine and cataract of ophthalmology.We analyzed and evaluated the data by the hospital information system,including inpatients quantity,average hospitalization time,preoperative waiting time,average total hospitalization expenses, average expense of medicine, percentage of medicine cost over total expense,degree of patients'satisfaction,confirmed diagnosis rate within 3 days,diagnostic coincidence rate of discharging and adimitting,the first degree medical record rate and so on.All these informations included pre-Cp and post-Cp.We analyzed and evaluated the effect of Cp by all these informations.The informations we studied came from the year of 2003 to 2007,and the year began clinical pathway was 2004.So we called non-CP group in the year of 2003,called Cp group from the year of 2004 to 2007,as controlled group.There were no significant differences between the two groups in terms of gender and age for each disease in four kinds of diseases.Result:As total number of admitted patients,there were significant differences in four kinds of diseases compared postCp with preCp, patients increased after Cp was taken on and it showed increased trend year by year.As all the hospitalization time, ,there were significant differences in Uterine leiomyoma and bronchi pneumonia group compared the preCp and post Cp,there were significant differences compared preCp and each year of postCp in Uterine leiomyoma group.There were significant differences compared preCp and each year after the second of of post Cp in bronchi pneumonia group .That meant that the hospitalization time show the reduced trend with the Cp taken on.As preoperative waiting time,there were significant differences in uterine leiomyoma and cataract two surgery groups.That meant preoperative waiting time decreased while Cp taken on.As total average hospitalization expenses,there were significant differences in four kinds of diseases compared preCp and postCp.That meant the total hospitalization expenses increase after Cp taken on.As medicine cost,there was significant differences in uterine leiomyoma compared preCp and post Cp,and there was decreased trend.There were significant differences in other three diseases and showed increased trend.Medicine cost account over total expense percentage, charts and tablets showed that there were significant differences in four kinds of diseases compared preCp and postCp.There were significant differences from the second year after Cp taken on compared with preCp,That means the percentage decreased after Cp taken on and with the improvement of Cp the percentage showed reduced trend.Other data difference analysis.There were no significant differences between the two groups on the degree of patients'satisfaction, convalescence rate, within 3 days,diagnostic confirmed diagnosis rate,coincidence rate of discharging and admitting, the first degree medical record,compared the non-CP group and CP group in four kinds of diseases.These accorded with the demand of three class first hospitals.At the same time there were no negative affection after Cp taken on and guarantee the medical quality.conclusionFirstly,by analyzing the result of Cp,we found that Cp not only don't weaken medical effect but also reduce the percentage of medical cost over total hospitalization expense.Secondly,Cp can accelerate medical resource utilization properly,standardize medical behavior.Thirdly,Cp can promote the assistance of medical staffs,improve medical management quality,absorb more patients,enhance the competition ability of hospitals.