临床路径单病种定额支付方式对医疗费用的影响

目的探讨临床路径单病种定额支付方式对医疗费用的影响。方法收集2009年至2011年重庆市黔江中心医院胆囊良性病变择期手术、急性单纯性阑尾炎、计划性剖宫产三个单病种临床路径前、后总费用、药品费用、检查费用资料。采用SPSSll．0统计软件，回顾性分析临床路径单病种管理前后各单病种的治疗费用情况。结果实行临床路径单病种管理后，胆囊良性病变择期手术、急性单纯性阑尾炎及计划性剖宫产总费用、药品费用，与临床路径单病种管理前相比，明显下降，差异有显著性（P〈0．05）；胆囊良性病变择期手术、急性单纯性I嗣尾炎检查费用略有下降，无显著差异（P〉O．05）；计划性剖官产检查费用略有上升，与实行临床路径单病种管理前相比，差异有显著性（P〈O．05）。结论临床路径单病种定额支付方式，能降低病种总费用、药品费用等费用及降低医疗成本，遏制医疗费用不合理增长，减少卫生资源浪费。

The Effect of Clinical Pathway Single Disease Quota Payment Mode on Medical Costs

Objective To discuss the effect of clinical pathway single disease quota payment mode on medical costs. Methods Collecting the total cost, drug costs, and inspection fee of gallbladder benign disease surgery, acute simple appendicitis, planned cesarean section during 2009 and 2011 in qianjiang central hospital. Analyze the treatment costs of single diseases before and after clinical pathway single diseases implementing by spssl 1.0. Re- suits Comparing to the medical costs before clinical pathway single disease management, the total cost and the drug expenses of gallbladder benign dis- ease surgery, appendicitis and cesarean section has ddramatic decline. It has significant difference （P 〈 0.05）. The check fees of gallbladder benign dis- ease surgery and cesarean section were lower. It has no significant difference （ P 〉 0.05）. The check fee of cesarean section was increased. It has sig- nificant difference （PP 〈 0.05）. Conclusion It can reduce the total cost of disease and drug fees, reduce health-care costs, curb the growth of unrea- sonable medical expenses, and reduce the waste of health resources.