Chin J Schisto Control ›› 2018, Vol. 30 ›› Issue (3): 278-281.

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Study on effect of clinical pathway implementation in advanced schistosomiasis with ascites

ZHOU Xiao-rong| SHAN Xiao-wei| ZHENG Li| LI Guo| LIU Si*   

  1. Hubei Provincial Center for Disease Control and Prevention| Wuhan 430079| China
  • Online:2018-07-02 Published:2018-07-02
  • Contact: LIU Si
  • Supported by:
    湖北省卫生厅血吸虫病防治科研项目(XF2012?10);湖北省科技计划项目(2018CFC897)

腹水型晚期血吸虫病实施临床路径的效果评价

周晓蓉|单晓伟|郑力|利国|刘斯*   

  1. 湖北省疾病预防控制中心(武汉430079)
  • 通讯作者: 刘斯
  • 作者简介:周晓蓉|女|硕士|副主任医师。研究方向:血吸虫病防治

Abstract: Objective To evaluate the effect of clinical pathway (CP) on the implementation of advanced schistosomiasis patients with ascites. Methods Totally 1 129 cases of advanced schistosomiasis patients with ascites but without other complications were selected randomly from the Performance Evaluation and Management System for Medical Treatment of Advanced Schistosomiasis Patients in Hubei Province from year 2011 to 2013. Among the patients, 754 cases were treated by CP (CP group ), and 375 cases were treated with traditional methods (NCP group), and the hospitalization days, hospitalization expenses, medicine proportions, treatment outcomes and degrees of satisfaction and health knowledge rates of the two groups were compared. Meanwhile, the variation of CP was calculated. Results The average length of hospital days of the CP group and NCP group were (13.85 ± 5.60) d and (17.92 ± 5.80) d, respectively, and the average hospitalization costs of the two groups were (4 699.14 ± 1 520.59) Yuan and (5 692.01 ± 1 616.66) Yuan, respectively, both the differences were statistically significant (both P < 0.05). Also the hospitalization cost structures of the two groups were remarkably different, the composition ratios of the inspection fee and accommodation fee in the CP group were lower than those in the NCP group, but the constituent ratios of the examination fee, diagnosis and treatment fee, drug charges and other expenses were higher than those in the NCP group (all P < 0.05). The awareness rate of health knowledge in the CP group was higher than that in the NCP group (P < 0.05), but there were no statistically significant differences in the treatment outcome and the degree of satisfaction between the two groups (both P > 0.05). The variation rate of CP was 9.02% (68/754). Conclusions The implementation of CP can decrease the days of hospital stay and medical expenses, improve the awareness rate on health knowledge of the patients. The CP treatment with low variation rate is applicable to advanced schistosomiasis patients with ascites but without complications.

Key words: Advanced schistosomiasis; Ascites; Clinical pathway; Effectiveness evaluation

摘要: 目的 评价临床路径(CP)在腹水型晚期血吸虫病(晚血)诊疗中的实施效果。方法 从湖北省晚血救治绩效评估管理系统中,随机抽取2011-2013年救治的无合并症的腹水型晚血患者1 129例, 其中采用CP治疗754例(CP组),采用传统治疗375例(NCP组),比较两组患者住院天数、住院费用、药占比、治疗转归、满意度和健康知识知晓率差异,并观察CP的变异情况。结果 CP组平均住院时间为(13.85 ± 5.60) d、平均住院费用为(4 699.14 ± 1 520.59)元,NCP组分别为 (17.92 ± 5.80) d和(5 692.01 ± 1 616.66)元,差异均有统计学意义(P 均< 0.05);两组住院费用结构亦有显著不同,CP组检查费、床位费构成比低于NCP组,但检验费、诊疗费、药品费及其他费用构成比高于NCP组( P均 < 0.05)。CP组健康知识知晓率较NCP组高(P < 0.05),两组患者治疗转归及满意度差异均无统计学意义(P均 > 0.05)。CP变异率为9.02%(68/754)。结论 实施CP能减少腹水型晚血患者的住院时间、降低医疗费用、提高患者健康知识知晓率。CP治疗变异率较低,适用于无合并症的腹水型晚血患者。

关键词: 晚期血吸虫病; 腹水;临床路径; 效果评价

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