| Objective: In this study,we studied the cost of hospitalization,length of hospital stay,preoperative preparation time,treatment cost,drug cost and auxiliary examination cost in the study of benign prostatic hyperplasia patients in five urology hospitals in Qiqihar area.At the same time through the organization of the questionnaire on the implementation of the clinical path of the medical staff of the clinical path of the implementation of the evaluation results,the organization of patients through the questionnaire to conduct hospital patient satisfaction survey.So as to assess the quality of the clinical path in order to provide important scientific reference for the relevant departments,while exploring the clinical path for medical reform to provide rationalization recommendations.Metholds: Collected from January 2015 to December 2015 in Qiqihar City,five comprehensive top three hospital urology surgery and the implementation of clinical path management of benign prostatic hyperplasia in 100 patients,while the choice of five comprehensive top three hospital urology did not implement the period from January 2014 to December 2014,100 patients with benign prostatic hyperplasia were treated with clinical pathways as controls.All 200 patients underwent surgical treatment.The surgical procedure was transurethral resection of the prostate.Through the hospital medical records system were obtained in patients during the total cost of hospitalization,the average length of stay,preoperative preparation time,treatment costs,drug costs,auxiliary inspection costs.The questionnaire was used to investigate the satisfaction degree and the cognitive path of the clinical path.Analysis using SPSS19.0 statistical software,the comparison between the measurement data using t test,the difference between the count data using the chi-square test for comparison,p <0.05 that the difference was statistically significant.Results: 1?The age of the 100 patients in the experimental group was between 45 and 70 years,with an average age of(58.68 ± 8.25)years.The mean age of the 100 patients was between 48 and 67 years(59.22 ± 7.96)years.There was no significant difference between the experimental group and the control group in the mean age(t = 0.471,p =0.638).There was no significant difference between the two groups in the educational level(x~2 = 0.558,p =0.906).2?There were 5 patients with complications in the experimental group and 95 without complications.There were 4 patients with complications in the control group and 96 patients without complications.There was no significant difference in the incidence of postoperative complications between the experimental group and the control group(p =1.000).3?The total cost of hospitalization between(1.45 ± 0.18)million and total hospital costs(1.61 ± 0.22)patients in the control group during hospitalization million and total hospital costs total hospital costs of patients and the control group of patients in the experimental group during the hospital stay of patients in the experimental group The difference was significant,the experimental group was significantly lower than the control group(t = 5.629,p = 0.000).4?The average hospital stay was(9.38 ± 1.73)days in the experimental group and(10.56 ± 2.35)days in the control group.The average hospital stay was lower in the experimental group and the control group(t = 4.044,p =0.000).5?The average hospital stay was(1.27 ± 0.38)days in the experimental group and 1.73 ± 056 days in the control group.The difference between the experimental group and the control group was statistically significant.The preoperative preparation time of the experimental group was lower than that of the control group(t = 6.797,p =0.000).6?Drug costs patients in the experimental group(0.418 ± 0.109)million drug costs patients in the control group(0.497 ± 0.136)million,the difference between drug costs and drug costs patients in the control group of patients in the experimental group were statistically significant,the experimental group The cost of drug was lower than that of the control group(t = 4.533,p =0.000).7?experimental examinations cost patients(0.331 ± 0.085)million patients in the control group examinations costs(0.379 ± 0.112)million,the difference between the patient with the patient examination charges & auxiliary control inspection costs experimental groups was statistically(t = 3.414,p =0.001).8?Antibiotic drug cost was the experimental group(0.086 ± 0.015)million,an antibiotic drug costs for the patients in the control group(0.093 ± 0.027)million,the difference between the experimental group antibiotic patient drugs cost control group was statistically(t = 2.266,p =0.025).9?There were 98 patients in the experimental group who were satisfied with the medical process and two were dissatisfied with the medical process.In the control group,87 patients were satisfied with the medical process and 13 were not satisfied with the medical procedure.The difference between the patients in the experimental group and the control group was statistically significant for the medical satisfaction rate.The patients in the experimental group had higher satisfaction rate than the control group(x~2 = 8.721,p =0.003).10?Patients in the experimental group into the clinical pathway,a total of 26 cases of reasons mutation,including reasons of health care(4 cases),the reason patients(11 cases),because the hospital(3 cases)and causes of the disease(8 cases).11?There are 50 medical staff clinical pathway for understanding cognition policy of 41 people fully answer 4 questions,there are 5 people answer 3 questions,there are 4 people answer 2 questions.12?(1)50 people in 40 people believe that after the implementation of clinical pathway to reduce the excessive medical doctor and reduce medical cost;10 people think that after the implementation of clinical pathway fails to reduce excessive medical doctors and to reduce medical costs.(2)45 of the 50 patients agreed that the implementation of the clinical pathway management achieved the goal of reducing the number of hospital stay.5 people think that the implementation of the clinical pathway management did not achieve the goal of reducing the number of hospital stay.(3)50 people in 35 people believe that after the implementation of clinical pathway,to ease the doctor-patient relationship and improve the satisfaction of patients;15 of people believe that after the implementation of clinical pathway,not to improve the satisfaction and ease the doctor-patient relationship to patients.(4)29 people in 50 people believe that after the implementation of clinical pathway can reduce the complications,improve the quality of medical purpose;21 people believe that after the implementation of clinical pathway did not reach to improve medical quality and reduce surgical complications.(5)42 of the 50 patients considered that the use of clinical pathway management had more standardized the use of antimicrobials;8 believed that the use of antimicrobial agents did not regulate the use of clinical pathway management.(6)37 of 50 people believe that the implementation of clinical pathway management does not limit the further improvement of medical technology;13 believe that the implementation of clinical pathway management limits the further improvement of medical technology.13?(1)50 people have 35 people think that the most important clinical stage of implementation;11 people think that the most important evaluation and improvement stage;4 people think that the most important stage of development(2)35 of the 50 people think that the "clinical path management" and "single disease fees" are different concepts,combined with;11 people think different concepts,mutual restriction;4 people think that the same concept,the two statements.(3)43 of the 50 patients believed that the common diseases,frequent diseases,more costs,small differences in surgical or disposal methods,and the type of diagnosis needed for hospitalization were suitable for clinical pathway management.7 people believe that simple general type applies to clinical pathway management.(4)38 people in 50 people believe that the optimization process,to speed up the diagnosis efficiency is prompted into the factors of clinical pathway management;7 people think work to strengthen the ability of medical staff,improve the technology level of the led into the factors of clinical pathway management;5 people that accelerate the turnover of beds increase the economic benefit of hospitals is to promote the patient into the factors of clinical pathway management.(5)46 of 50 people considered it necessary to perform clinical pathways in hospitals and departments;4 considered it unnecessary to develop clinical pathways.(6)47 of 50 people considered the clinical pathway to be successful;3 believed that clinical pathways should be carried out in the future.(7)36 of 50 people think that the hospital management concept is the biggest challenge facing the development of clinical path;9 people think the concept of medical personnel is the biggest challenge facing the development of clinical path;5 people think the current hospital payment afterwards is the biggest challenge facing the development of clinical pathway.(8)48 of 50 people think of "standardization" to achieve coordination between regions through the medical clinical pathway;2 people think of "standardization" can not achieve synergy between regions through the medical clinical pathway.(9)36 of 50 people in that hospital clinical departments,medical departments and other relevant administrative departments of collaboration of clinical pathway with the situation;9 people think the hospital clinical departments,medical departments and other relevant administrative departments of collaboration of clinical pathway with the situation;6 people think the clinical departments,hospitals and other health departments and relevant administrative departments on the collaboration of clinical pathway with difference.14?(1)40 of 50 people believe that after the implementation of clinical pathway to reduce the excessive medical doctor and reduce medical cost;10 people think that after the implementation of clinical pathway fails to reduce excessive medical doctors and to reduce medical costs.(2)45 of the 50 patients agreed that the implementation of the clinical pathway management achieved the goal of reducing the number of hospital stay.5 people think that the implementation of the clinical pathway management did not achieve the goal of reducing the number of hospital stay.(3)35 of 50 people believe that after the implementation of clinical pathway,to ease the doctor-patient relationship and improve the satisfaction of patients;15 people believe that after the implementation of clinical pathway,not to improve the satisfaction and ease the doctor-patient relationship to patients.(4)29 of 50 people believe that after the implementation of clinical pathway can reduce the complications,improve the quality of medical purpose;21 people believe that after the implementation of clinical pathway did not reach to improve medical quality and reduce surgical complications,the purpose of.(5)42 of the 50 patients considered that the use of clinical pathway management had more standardized the use of antimicrobials;8 believed that the use of antimicrobial agents did not regulate the use of clinical pathway management.(6)37 of 50 people believe that the implementation of clinical pathway management does not limit the further improvement of medical technology;13 believe that the implementation of clinical pathway management limits the further improvement of medical technology.Conclusions: After the implementation of clinical path management,the patient's hospital stay shortened,the total cost of hospitalization and the cost was significantly reduced,the patient's economic burden can be reduced.The incidence of complications in patients is reduced.Treatment behavior is more standardized,care behavior is more standardized,patients also more clearly understand their own treatment process.Promote the communication between doctors and patients,the patient's medical satisfaction improved significantly.Health care workers for the implementation of the clinical path of the overall affirmation and support,but the medical care for the clinical path of the relevant cognition is still different,the clinical path between health care workers,with the awareness has yet to be improved.Health care and hospitals should reduce the occurrence of variation from their own point of view. |
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