电子结肠镜下大肠息肉高频电凝电切术实施临床路径对医药费用控制的效果评估

目的：探讨电子结肠镜下治疗大肠息肉实施临床路径对医药费用控制的效果，为临床治疗大肠息肉实施临床路径管理提供循证医学证据。方法：根据入选标准，将大肠息肉患者121例随机分为临床路径组（n=69）与非临床路径组（n=52），比较2组电子结肠镜下大肠息肉高频电凝电切术的相关费用及患者满意度。结果：临床路径组的住院总费用、药品费用和手术费用分别为（3871．26±802．30）元、（344．61±105．13）元和（412．64±73．46）元，非临床路径组的住院总费用、药品费用和手术费用分别为（4384．38±1040．36）元、（526．95±162．40）元和（496．78±133．70）元，2组比较差异均有统计学意义（P〈0．05或P〈0．01）。与非临床路径组比较，临床路径组平均住院时间和住院床日费用均明显减少（P〈0．01），分别减少了1．98d和19．45元，患者的满意度明显提高（P〈0．01）。结论：电子结肠镜下大肠息肉高频电凝电切术实施临床路径管理能够改善医疗质量，缩短了患者住院时间，减少其住院费用，更好地控制医药费用，提高了患者对医疗质量的满意度。

Effect Evaluation of Medical and Pharmaceutical Expense Control of Clinical Pathway in High Frequency Electric Coagulating and Cutting Operation for Colorectal Polyps under Electronic Colonoscopy

OBJECTIVE： To investigate the effect of clinical pathway on medical and Pharmaceutical expense control in thera- py for colorectal polyps under electronic colonoscopy, and to provide evidence-based medicine evidences for clinical pathway which is applied in the therapy for colorectal polyps. METHODS： 121 patients with colorectal polyps were divided into clinical pathway group （n=69） and non-clinical pathway group （n=52） according to inclusion criteria. The related expenses of and patient satisfaction were compared between 2 groups. RESULTS： Total hospitalization cost, drug cost and surgery cost of clinical pathway group were （3 871.26±802.30） yuan, （344.61 ± 105.13） yuan and （412.64 ± 73.46） yuan, respectively; and those of non-clinical pathway group were （4 384.38 ± 1 040.36） yuan, （526.95 ± 162.40） yuan and （496.78 ± 133.70） yuan, respectively. There was sta- tistical significant difference between 2 groups （P〈0.05 or P〈0.01 ）. Compared with non-clinical pathway group, the average hos- pitalization duration and daily bed cost of clinical pathway group were decreased evidently （P〈0.01）, and they reduced by 1.98 day and 19.45 yuan, respectively. The satisfactory degree of patients were improved significantly （P〈0.01）. CONCLUSION： Ap- plication of clinical pathway in high frequency electric coagulating and cutting operation for colorectal polyps under electronic colo- noscopy could shorten hospitalization duration of patients, decrease hospitalization costs, control medical and pharmaceutical cost and improve satisfactory degree of patients to the quality of medical care.