临床路径在医院质量管理中的应用与思考

目的探讨临床路径对医院质量管理的现实意义。方法选取2011年1~12月我院腹股沟疝、老年性白内障和混合痔三个临床路径病种患者654例为观察组,选取2010年1~12月我院相同治疗方式治愈出院的腹股沟疝、老年性白内障和混合痔三个病种患者738例为对照组。以临床路径为标准住院流程,观察组严格按流程要求安排每日的诊疗护理,对照组仍遵循传统常规进行诊疗护理。以平均住院日、住院费用和医药比卫生经济学指标作为评价指标,将两组进行对比分析。结果观察组平均住院日、住院费用和医药比均明显低于对照组,差异有高度统计学意义（P〈0.01）。结论临床路径（包含阶段性临床路径）作为一种质量效益型医疗管理模式,对科学、有效、合理地控制医疗成本,提高医院运行效率,提高医院的竞争能力有重要意义。

Application and thinking of clinical pathway in quality management of hospital

Objective To discuss the practical significance of clinical way to the hospital quality control.Methods 654 patients with inguinal hernia,cataract and mixed hemorrhoid disease were selected as observation group from January 2011 to December 2011,738 patients with inguinal hernia,cataract and mixed hemorrhoids were selected by the same treatment as the control group from January 2010 to December 2010.According to the standards of hospital procedures as the clinical pathway,the procedures required of daily treatment care of observation group was arranged in strict accordance,the control group still followed the traditional routine clinic care,the two groups of evaluation indexes such as the average length of stay,hospital costs and the rate of medical economics health indicators were analyzed.Results The average length of stay,hospital costs and the rate of medicine of observation group were significantly lower than that of the control group,the differences were significant(P < 0.01).Conclusion Clinical pathway(including stage clinical pathway) is a quality and efficiency of medical management,which is scientific,effective and reasonable in controlling of medical costs,can improve hospital efficiency,and it is important to improve the competitiveness of the hospital.