我院5个病种实施临床路径前后的药品费用研究

目的:探索临床路径模式对我院药品费用的影响。方法:采用回顾性调查方法,选择治疗方案较单纯、病例数相对较多且无其他合并症,或虽有其他合并症但不需要治疗且不影响疾病本身发展和转归的5个病种,依据是否实施临床路径管理,将2010年入住我院并实施临床路径管理模式的上述5个病种的住院患者作为受试组,2009年未实施临床路径管理的对应患者作为对照组,统计2组患者的住院天数、药品费用和抗菌药品费用,并进行分析比较。结果:纳入本研究的5个病种中,受试组平均住院天数均较对照组下降,且计划性剖宫产、老年性白内障和腹股沟疝3个病种的平均住院天数差异有统计学意义;平均药品费用相比,结节性甲状腺肿和子宫平滑肌瘤2个病种受试组均较对照组增加,而计划性剖宫产、老年性白内障和腹股沟疝3个病种受试组均较对照组降低,且计划性剖宫产2组差异有统计学意义;除老年性白内障组外,其余4个病种的平均抗菌药物费用受试组均较对照组下降,且差异有统计学意义。结论:我院临床路径的实施规范了医师处方行为,促进了抗菌药物费用的降低,但未能完全实现药品费用的降低。

Comparison of Drug Expenses for 5 Types of Diseases before and after Implementation of Clinical Pathway Mode in Our Hospital

OBJECTIVE：To investigate the effects of clinical pathway mode on drug cost in our hospital.METHODS：Retrospective analysis was used and 5 types of diseases with simple treatment scheme and large case number and without other complications or with complications which didn＇t required treatment and affected development and outcomes were collected.According to clinical pathway management,qualified inpatients receiving clinical pathway management from 5 types of diseases were chosen as trial group,and those without receiving clinical pathway management were chosen as control group.The hospitalization days,drug expenses and antibacterial drug cost were analyzed and compared between 2 groups.RESULTS：Among included 5 types of diseases,average hospitalization days of trial group decreased,compared with control group.There was statistical significance in the difference of average hospitalization days in planned caesarean operation,senile cataract and inguinal hernia;average drug cost of nodular goiter and leiomyoma of uterus in trial group increased,compared with control group,while that of planned caesarean operation,senile cataract and inguinal hernia decreased.There was statistical significance of 2 planned caesarean operation between 2 groups.Except senile cataract,average antibacterial drug cost of other 4 diseases in trial group decreased,compared with control group,there was statistical significance.CONCLUSION：The implementation of clinical pathway contributes to physicians＇ prescribing behavior standardization and antibacterial drugs cost reduction.However,the drug cost does not decrease completely.