Effectiveness analysis on clinical pathway of common bile duct stones day surgery
Wu Huatun1, Huang Xiaoguang2, Zhu Jianqian1
1 Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou 310006, China; 2 School of Health Policy and Management of Nanjing Medical University
Abstract：Objective To analyze the effects of clinical pathway of day surgery for common bile duct stones, and provide useful lessons for promoting the clinical pathway of day surgery.Methods Data of 576 patients with common bile duct stones from a tertiary hospital in Hangzhou from January 2016 to December 2017 were collected, and general conditions, hospitalization expenses, hospitalization time, and medical quality were compared and analyzed among the daytime path group, the daytime common group, and the common ward group.Results After the clinical pathway of day surgery for common bile duct stones was achieved, the per capita hospitalization costs, drug costs, drug proportion, consumables costs, examination costs, treatment costs and nursing expenses reduced (P<0.01), and the average length of stay shortened (P< 0.01), without significant change in discharge outcome, postoperative complications, unplanned re-admission within 31 days, and unplanned reoperation (P>0.05).Conclusion The clinical pathway of day surgery for common bile duct stones can reduce patient burden, control drug ratio, improve medical service efficiency, and reduce medical risks. The key link management should be strengthened, and the service chain extended to promote "hospital surgery & community care" clinical pathway of day surgery.
[1] 刘成凤,黄辉,陈坚,等.基于流程再造的日间手术管理与效果评价[J].中国卫生事业管理,2017(8):577-581. [2] 瞿延,黄培,喻子儒,等.1000例日间手术路径化管理效果分析[J].中华医院管理杂志,2017,33(4):289-290. [3] 白洁,薛迪.临床路径的发展与我国实践[J].中国卫生资源,2018,21(5):378-382. [4] KAREN A, MARGARET J, GOLOSINSKIY A. Ambulatory surgery in the united atates[J]. National Health Statistics Reports,2009,11(28):1-28. [5] 于丽华.中国日间手术发展的历程与展望[J].中国医院管理,2016,26(6):16-18. [6] 马洪升,戴燕.日间手术治疗模式国内外发展简述[J]. 中国医院管理,2012,32(1):47-48. [7] 徐雪慧.临床路径管理对患者平均住院日的影响因素分析[J].中国卫生质量管理,2016,23(5):49-51. [8] 袁磊,李亮,钱招昕,等.开展日间手术对平均住院日影响的间断时间序列研究[J].中华医院管理杂志,2018,34(10):805-809. [9] 张莹,辛科道,黄辉,等.日间手术存在的问题与发展策略研究[J].医学与哲学(B),2018,39(1):84-87. [10]刘文雅,魏文斌,宋旭东,等.老年性白内障日间手术临床路径模式效果分析[J].中国医院管理,2017,37(9):42-44. [11]方淑珍,李福明.乳腺癌临床路径变异原因及其分析[J].医院管理论坛,2012,29(7):41-43. [12]黄培,易利华,钱红英.医院日间手术的创新实践与思辨[J].医学与哲学(B),2017,38(5B):83-85. [13]白雪,马洪升,罗利.中外日间手术发展对比研究及展望[J].中国医院管理,2014,34(5):35-37. [14]林夏,马洪升,王琪,等.提升我国日间手术管理水平的思考与建议[J].中国医院管理,2017,37(7):41-42. [15]TOFTGAARD C, PARMENTIER G. International terminology in ambulatory surgery and its worldwide practice[C]. International Association for Ambulatory Surgery,London,2006. [16]顾炜珺,赵列宾,郭薇薇.儿科日间手术开展现状及风险管理探索[J].中国卫生资源,2017,20(4):352-355. [17]乔梁,李勇杰.日间手术的精准内涵及其发展策略分析[J].中国医院,2016,20(11):69-72.
