Evaluations Of The Clinical Pathway Of Congenital Muscular Torticollis In Beijing Children's Hospital

Objective:To investigate the efficacy of the clinical pathway introduced in children with congenital muscular torticollis in Beijing Children's Hospital affiliated to Capital Medical University.Methods:The clinical pathways not implemented of 156 patients with congenital muscular torticollis were selected as the control group from January 2009 to January2012.The clinical pathways implemented of 126 patients with congenital muscular torticollis were enrolled as the test group.Using the retrospective and contrastive analysis method to observe and compare the difference between the twogroups.The observation indicators include:preoperative hospital stay,postoperative hospital stay,total length of hospital stay,hospital costs,antibiotics used,reoperation,complications and so on.Results:The preoperative hospital stay,postoperative hospital stay,total length of hospital stay in clinical pathway group(3.17±1.91,3.39±1.00,6.38±2.32d)were shorter than that in the control group(4.00±2.27,3.90±1.26,7.88±2.92d).The bed expenses,anesthesia fees(161.90±59.25,254.82±50.87 CNY)were lower than that in the control group(187.54±72.38,269.10±25.46 CNY).The cost of operation,the cost of western medicine,the cost of disposable materials,the total hospital costs(713.18±61.47,2517.23±987.17,1045.97±407.41,6968.05±1610.96 CNY)were higher than that in the control group(636.19±31.49,1626.86±702.80,674.52±310.09,5591.21±1005.85 CNY).All of above,differences were statistically significant(P<0.05).In the control group,2cases had wound bleeding after operation,and there was no obvious complication inthe test group.1 case underwent secondary surgery in the control group and no patients in the test group.The ratio of the control group using antibiotics more than 24 hours after operation is 83.33%(130/156),while the ratio of the test group is0.79%(1/126).The variation rate after implementing the clinical pathway was49.64%(69/139).Conclusion:The implementation of clinical pathways can shorten the length of hospital stay in children with congenital muscular torticollis,regulate the use of antibiotics and no significant complications after surgery.While the cost of hospitalization increased,and there is a high variation rate,so it is need for the clinical pathway to be refined and promoted.And it is necessary to optimize the clinical pathway before it is adapted in clinic.