急性心肌梗死医疗质量改进效果分析

目的 分析急性心肌梗死病种全程医疗质量管理影响因素,提高该病种的救治和管理水平.方法 选取2012年全部进行病种质量监控的226例急性心肌梗死病例为监控组、2011年同期未监控的193例为非监控组,对结果质量指标和环节质量指标进行综合比较、评价.结果 监控组与非监控组的危重病例率相等（P＞0.05）,监控组在治愈好转率、平均住院日、低密度脂蛋白胆固醇评估、健康教育等方面,均优于非监控组（P＜0.05）;药物溶栓和一般治疗的患者平均费用、药物溶栓时间、24小时内左心室功能评价完成率均有改善,但差异不明显（P＞0.05）.结论 采用流程再造、科室培训、临床路径应用、病历质量监控、追踪检查法和品管圈等措施,可持续改进急性心肌梗死病种管理质量.

Effect Analysis of Medical Quality Improvement of Acute Myocardial Infarction

Objective To analyze the quality influence factors of acute myocardial infarction, and improve the treatment and the management level of the disease. Methods Choosing 226 cases of acute myocardial infarction with quality control as control group in 2012, and 193 cases of acute myocardial infarction without quality control as non-control group in 2011 at the same time. The results quality indicators and link quality indicators are comprehensively compared and evaluated. Results The extreme case rates of control group and non-control group are the same（ P 〉 0.05）. The cure and improvement rate, average length of stay, low density lipoprotein cholesterol assess, health education of control group are better than those of non-control group（ P 〈 0.05）. The average cost, drug thrombolysis time, left ventricular function evaluation finishing rate within 24 hours of thrombolysis and general treatment patients are also had improved. But the difference is not obvious（ P 〉 0.05）. Conclusion We can continue improve the quality of management of acute myocardial infarction diseases by using process reengineering, department training, the application of clinical pathway and medical record quality monitoring, tracking test and quality control measures, etc.