实施临床路径的医院概况及其成因分析

目的通过对我国实施临床路径的医院的情况进行描述、分析，发现其中存在的问题，提出建议。方法文献研究法，即分析以“临床路径”为关键词，在维普中文科技期刊数据库中搜索到的1051篇相关文献．同时结合查阅互联网上的相关信息以及电话回访核对信息的方法。结果我国实施临床路径的医院有162家，占全国医院总数的0．82％：162家医院在全国的分布情况为：华东、华中、华北、华南、东北、西南和西北分别占37．7％、17．9％、14．8％、13．0％、7．4％、4.9％和4.3％;实施临床路径的医院在级别和隶属关系上存在不同，三级医院实施的数量要多于其它级别的医院；82．7％的医院实施临床路径的病种数量少于10个，4．8％的医院实施的病种数量在50个以上；临床路径实施的持续时间平均为2．02年。结论我国实施临床路径的医院数量少，区域分布不平衡，进入临床路径的病种数量相对较少，病种较单一；临床路径实施的持续时间较短。我国临床路径的实施与推广，需要政府政策、医院、患者多方面的努力，为临床路径的实施与推广奠定更好的基础。

Survey and Analysis of the Hospitals Implementing Clinical Pathway

Objective To find the problems and bringing up suggestions for the hospitals implementing clinical pathway, through describing and analyzing the condition of them. Methods Entering ＂clinical pathway＂ as the keyword, 1051 literatures were found in the Chinese Science and Technology journals in PubMed NCBI. Literature research methodology, combined with information on the internet and telephone interviews method, were applied to this paper. Results There were 162 hospitals in China that implemented clinical pathway, accounting for 0.82% of the total hospitals. The distribution as follows, East China, Central China, North China, South China, Northeast of China. Southwest of China and Northwest of China, respectively were 37.7%, 17.9%, 14.8%, 13.0%. 7.4%, 4.9% and 4.3%. The hospitals that implemented clinical pathway differed in the level and subordinate relationship. There were more tertiary hospitals than hospitals of other levels. There were 82.7% of the hospitals that implemented less than 10 kinds of diseases and 4.8% that implemented more than 50 kinds of diseases for clinical pathway. The average duration for implementing clinical pathway was 2.02 years. Conclusions In China a few hospitals implemented clinical pathway. The regional distribution was uneven. There was relatively a small number of diseases implemented in clinical pathway, and the kind of disease is relatively single. The duration of implementing clinical pathway was short. It requires government policies, hospitals, and patients in all aspects to adjust the implementation and promotion of clinical pathway and lay a better platform.