Research On Effect Evaluation With The Implementation Of Clinical Pathyway In Shanghai

The continuous increase of medical expenses is the critical problem that health department paies attention to.To control the expenses of medicine and irrational diagnosis and treatment,the country is actively piloting clinical pathway and required all localities to combine clinical pathway management with payment reform.[Objective] The research focus on work of clinical pathway in Shanghai.To learn the effect of controlling LOS and hospitalization expenses after the clinical pathway work implementation in childhood pneumonia by medical record review.To learn doctors' cognition and attitude of the work by questionnaire and focus on the doctors who are not satisfied with clinical pathway.To provide reference for advanced optimization of the work and payment reform.[Methods] To collect the documentation of childhood pneumonia and clinical pathway at home and abroad by literature research method and summarized research contents and methods in current research.To collect the related expenses information of childhood pneumonia inpatients by medical record collection method and learn the the status quo of hospitalization expenses of childhood pneumonia and the effect of clinical pathway.To learn doctors' cognition and satisfaction of the work by questionnaire and learn the emphasis and difficulties of clinical pathway management.To analyze data by mathematical statistical method and propose related policy suggestion.[Result] The status quo of childhood pneumonia and the effect of clinical pathway: The number of childhood pneumonia has increased,the hospitalization expenses rised and the proportion of drug decreased.The status of implementation of childhood bronchopneumonia clinical pathway is good that can control medical expenses and improve medical efficiency.Doctors' cognition and satisfaction of clinical pathway: Doctors' satisfaction to clinical pathway is relatively high(2.98±0.71 points).The cognition level and satisfacion with some elder doctors who are high educated and have high professional titles are relatively low.Single disease payment can be combined with clinical pathway.[Conclusion] The clinical pathway management of childhood bronchopneumonia has worked.The initiative of doctors to clinical pathway is high.Meanwhile,we should pay attention to the focus groups who are not satisfied with clinical pathway.Single desease payment of childhood pneumonia can be carried out.We suggest to perfect the train and related policies of clinical pathway to improve the satisfication of elder doctors.We suggest to strengthen the management of clinical pathway in hospital to improve medical efficiency and quality.We also suggest to push the implement of clinical pathway and continuously research single disease payment of childhood pneumonia.