A Study On The Cost Accounting And Cost Comparative Analysis Of Cesarean Delivery Clinical Pathway

Objective Through reckoning the standard disease cost of cesarean section based onclinical pathway and comparing it with the disease cost of cesarean section under themode of traditional diagnosis and treatment, to explore the influence of implementingclinical pathway on disease cost, pharmaceutical cost, consumables cost, examinationcost, assay cost, ward and hospital beds cost, medical and nursing human cost, and toprovide theoretical and practical basis for setting down a reasonable price of singledisease. Materials and methods Choosing98cases of gynecology and obstetricspatients which were carried out cesarean delivery Clinical pathway in No.101hospitalof PLA in2010.11～2011.10as pathway group, setting100cases of those not carriedout clinical pathway as control group. All the cases of pathway group and control groupmet inclusion criteria of cesarean delivery clinical pathway. Through hospitalinformation system and artificial collection of diagnosis and treatment material and costinformation of pathway group and control group, the costs of two groups werecalculated respectively and compared. Results (1) There was not statisticaldifference between two groups in age（P＝0.684＞0.05）. The time of hospitalization inpathway group was shorter than that in control group, and there was statisticaldifference between them (P＝0.000). Total cost of pathway group decreased obviously,and there was statistical difference between two groups (P＝0.000).(2) The cost ofpharmaceutical,consumables, examination, assay, surgery human, operating room,nursing human, ward and hospital beds in pathway group were lower than those incontrol group, and there was statistical difference between them (P＜0.05).Pharmaceutical cost in pathway group reduced by64.91％. Nevertheless, medical andnursing human cost in pathway group was higher than that in control group, and there was statistical difference between them (P＝0.000).(3) In the cost structure,pharmaceutical cost ratio in pathway group had the greatest reduction, dropped from31.89%to15.83%.(4) The proportion of consumables cost, operating room cost,wardand hospital beds cost,surgery human and medical human cost in pathway group weremore than those in control group to some extent. Nursing human cost and examinationcost of two groups had equal proportion. Conclusion This research holds the pointthat as a standardized working process and quality control tool, clinical pathwayregulating diagnosis and treatment behavior, preventing excessive medical treatment,can be an effective way to control disease cost and promote the rational use of healthresources, which is based on the premise that medical service quality is guaranteed.Reckoning the standard disease cost of cesarean section based on clinical pathway,withdiagnosis and treatment process regulated while the standard cost of disease reckoned,not only can reduce cost differences, enhance the credibility of disease cost, but workout the more scientific and reasonable disease cost.