Application And Analysis Of Clinical Pathway In The Control Of Single Disease Medical Expense

ObjectiveThree single diseases were compared and analyzed in terms of admissiondays and medical expense structure, the cause for the medical expensedeviation before and after implementing clinieal pathway in the hospital of GradeⅢ Level.And appropriate countermeasures and suggestions were proposed inorder to provide the theoretical basis for optimizing clinical pathwaymanagement, controlling medical expense excessive growth, promoting thelevel of hospital management continuous improvement and developping thesingle disease medicine expense standards with the health administration andhealth insurance institutions.MethodsUsed retrospective study of experimental methods,collected three singlediseases with mature treatment,less variation, considersale and consistencybetween diagnosis and treatment in the hospital of Grade Ⅲ Levelfrom January2010to December2011in this study, including cataract,intracerebralhemorrhage and chronic subdural hematoma. Make the group with using clinicalpathway during hospitalization for observation group, make the group withoutclinical pathway but with same disease and comparable basic Information ofobservation group during hospitalization for control group.The patienes’sociological characteristics, clinical indicators and hospitalization expense werecollected by the hospital medicine recording information. The database wasestablished, the statistical analysis used SPSS18.0, numeration date were described as frequency, hypothesis test were performed with χ2text and Ttext,statistical inferences were conducted with T text,and the two-side significanttest level was set at as α=0.05.ResultsThe two groups have no significant difference in age, gender, and feepayment method(P>0.05), the average cost of hospitalization for observationgroup with three diseases have lower,the patients with intracerebral hemorrhagehad the largest decline in these groups, reduced616.68yuan; threeobservation groups patients had shortened in average hospital days; The bedcharges, surgery fees, inspection fees, laboratory fees, treatment costs,material costs, nursing care and other costs of three observation group patientshave also decreased (P less than0.05), it had a statistically significantdifference; The average drug costs for the two groups of patients with cataractwas reduced from840.14yuan to803.86yuan (P=0.016), the difference hadstatistically significant, but the two groups of chronic subdural hematoma andintracerebra hemorrhage patients’ average drug costs were no significantdifference (P=0.382and P=0.408). The proportion of drug costs in thehospitalization expense with the three observation groups after the clinicalpathways implementation were14.39%(cataract),66.39%(intracerebralhemorrhage) and57.47%(chronic subdural hematoma), cerebralhemorrhageand patients with chronic subdural hematoma, intracerebralhemorrhage and chronic subdural hematoma patients’ proportion is still high,and the percentage of drug costs in the hospitalization expense with the threeobservation groups were increased0.51%,3.15%,2.33%compared with thethree control groups.ConclusionsClinical pathway had significant effect on shortened admission days,lowered hospitalization expenses, speeded up the bed turnover rate and promoted the doctor-patient relationship. But we find the clinical path in thecontrol of drugs remains further improvement through this research. As animportant part of the hospitalization expense, medicine cost is the key to controlthe excessive growth of hospitalization expense effectively. The drugscontrolling should be put on the use of drugs, especially the use of antibiotics,so,government should increase financial input, establish and improve themedical insurance system, optimize clinical pathway, regulate doctors’medication behavior, transform the situation of drugs supporting mediinel,implement the DRGs-PPS system, enhance the clinical pathway supervision,make clinical pathway play a greater role in controlling hospitalization expense,reduce the patients’ economic burden, and improve the level of hospitalmanagement...