The Exploration And Effect Evaluation Of TCM Clinical Pathway For Outpatient Post Infectious Cough

BackgroundPost infectious cough is the common cause of sub-acute cough, with the high incidence. Frequent medical visits, extensive use of antibiotics and cough medicine have serious impact on quality of life and social activities, resulting in unnecessary waste of medical resources. TCM has been reported to have a unique advantage on the diagnosis and treatment of this disease. But in existing research, it hasn’t formed a unified understanding, the treatment and diagnosis process of post infectious cough are not standardized, there are various means. With the advance of China’s health care reform, the medical insurance system for continuous improvement, improving health care quality, reducing waste of resources, and establishing a single disease standardized treatment programs is the development trend. The clinical pathway which rises in1990’s is a worthy specific method to attempt, it can effectively reduce health care costs, improve quality of care, and standardize the treatment process. However, this study is still in the primitive stage, not been reported in the literature. Therefore, it is necessary to carry out a prospective clinical study on the basis of constructing a reasonable clinical pathway.Object i veTo evaluate the effect of TCM clinical pathway for post infectious cough, providing scientific evidence for implementation, optimization and promotion of clinical pathway.Methods Guangdong Provincial Hospital of TCM department of respiratory medicine establish TCM clinical pathway of post infectious cough in early time, by literature research, experts consultation, consensus research, and clinical epidemiological survey, which treatment including wind-heat, wind-dry, wind-cold and wind prescriptions. On the basis, this thesis use non randomized concurrent controlled method, select60outpatients who were diagnosed post infectious cough disease from Guangdong Provincial Hospital of TCM department of respiratory medicine were divided in to2groups in accordance with the attending doctor, clinical pathway group and the conventional therapy group. Each group has30cases. Collect efficacy evaluation, health economics indicators, service satisfaction indicators, and put all information into Epidata3.1database, then convert to SPSS files, use SPSS17.0statistical software to establish a database; test the homogeneity of the two groups of patients; take cough score before and after treatment, treatment days and so on as evaluations of the clinical efficacy, compare two groups differences; with the cost, patient satisfaction, using the descriptive and deductive statistical analysis to evaluate effect of clinical pathway.The resultsThis study included60patients of post infectious cough. Among them, the clinical pathway group had30patients, in which3cases dropped off, but no case was excluded; the conventional therapy group had30patients, in which3cases dropped off, but no case was excluded. The gender, age distribution, sex, disease duration, cough score (day, night and total) before treatment between two groups had no significant difference (P>0.05). The synthetic effect, cough score before treatment, in treatment and after treatment between two groups showed no statistical significance (P>0.05). Both the clinical pathway group and the conventional therapy group indicated a downward trend in total cough score. Compared with the conventional therapy group, the clinical pathway group took shorter treatment days (5days vs6days), two groups difference was significant (P<0.05). The average daily treatment cost and total cost of clinical pathway group are lower than the conventional therapy group (P>0.05). Patients received the clinical pathway accounted for88.9%,11.1%do not fully accept. On patient satisfaction, the results showed that patient satisfaction with treatment services of the clinical pathway group better than the conventional therapy group (P<0.05). The satisfaction of two groups on treatment days, clinical efficacy and medical expenses were not significant differences (P>0.05).ConclusionThe TCM Clinical Pathway for Outpatient Post Infectious Cough effectively reduce treatment days, improve patient care satisfaction, standardize medical diagnosis and treatment behavior, should be widely applied.