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.
[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。.
Keywords: Advanced schistosomiasis; Ascites; Clinical pathway; Effectiveness evaluation.