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目的调查分析骨科临床路径实施的现状,评价临床路径的实施效果。方法采用回顾性调查病历的方法,抽取临床路径实施前后股骨头坏死、腰椎间盘突出症、锁骨骨折的住院病案,采用t检验、秩和检验等统计方法对比。结果临床路径实施前后,股骨头坏死的住院天数和住院总费用没有显著性差异;腰椎间盘突出症的人均住院天数缩短2天,住院总费用减少824元,差异具有统计学意义;锁骨骨折的人均住院天数缩短3天,住院总费用减少1089元,差异具有统计学意义。结论临床路径的实施有助于减少无效、低效住院日,控制住院天数,降低住院费用。
Objective To investigate and analyze the status quo of clinical practice of orthopedics and evaluate the effect of clinical pathway. Methods By retrospectively investigating the medical record, the inpatient medical records of femoral head necrosis, lumbar disc herniation and clavicular fracture before and after the implementation of clinical pathology were collected and compared by t test, rank sum test and other statistical methods. Results Before and after the implementation of clinical pathology, there was no significant difference between the days of hospitalization and the total cost of hospitalization for femoral head necrosis. The average length of stay of hospitalized patients with lumbar disc herniation was shortened by 2 days and the total cost of hospitalization was reduced by 824 yuan, the difference was statistically significant. Hospitalization days shortened 3 days, total hospital costs decreased 1089 yuan, the difference was statistically significant. Conclusion The implementation of clinical pathway helps to reduce ineffective and inefficient hospitalization days, control hospitalization days and reduce hospitalization costs.