临床路径实施前后我院3个病种的抗菌药物使用与费用分析

目的:评价临床路径在我院3个病种中的应用效果。方法:采用回顾性调查方法,将我院2012年1-12月结节性甲状腺肿、良性乳腺癌、腹股沟疝3个病种共559例患者实施临床路径管理(路径组),选择前一年同期(2011年1-12月)同类疾病患者共532例作为对照组。观察两组患者抗菌药物应用率、抗菌药物选择种类、首剂给药时机、停药时间、平均给药疗程、联合用药、平均术前住院时间、平均住院时间、人均住院药费、人均住院总费用的差异。结果:与对照组相比,路径组患者抗菌药物使用率降低,抗菌药物种类选择合理性提高,首剂给药时机合理率增加,平均给药疗程缩短,联合用药比例降低,平均住院时间、人均住院药费、人均总费用降低(P<0.05)。结论:临床路径能规范抗菌药物的预防使用,缩短住院天数,减少医疗费用,值得推广。

Analysis of the Application and Expenses of Antibiotics in 3 Types of Diseases in Our Hospital before and after the Implementation of Clinical Pathway

OBJECTIVE： To investigate the effects of clinical pathway mode on the cost and application of 3 types of diseases in our hospital. METHODS： Using retrospective method, a total of 559 patients with nodular goiter, benign breast cancer or inguinal hernia during Jan.-Dec. 2012, who received clinical pathway management, were included in pathway group; 532 patients with same diseases during corresponding period of last year （Jan.--Dec. 2011） were included in control group. Utilization ratio of antibiotics, types of antibiotics, initial medication timing, duration of drug withdrawal, average treatment course, drug combination, average preoperative hospitalization day, average hospitalization day, hospitalization cost per capita and total hospitalization cost per capita were observed in 2 groups. RESULTS： Compared with control group, the utilization of antibiotics, average treatment course, the proportion of drug combination, average hospitalization day, hospitalization cost per capita and total hospitalization cost per capita were decreased, while the rationality of antibiotic selection and initial medication timing were increased （P〈0.05）. CONCLUSIONS： The implementation of clinical pathway contributes to physicians＇ prescribing behavior standardization and antibiotics cost reduction, which is worthy of spreading.