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目的探讨脑卒中多模式救治下的临床路径实施方法与改进措施,评价其医疗质量和卫生经济学效果。方法 (1)以2013年9月-2014年8月神经内科脑梗死和脑出血住院患者为传统治疗组,以同期同病种患者为多模式救治组,比较临床路径实施情况。(2)以临床路径实施前1年脑梗死(ICD-10:I63)和脑出血(ICD-10:I61)住院患者为传统组,以实施临床路径1年符合同病种临床路径并完成的住院患者为临床路径组,评价两组数据。结果多模式救治组比传统组脑梗死和脑出血临床路径入径率、完成率提高,变异率降低。实施临床路径前后,脑梗死和脑出血患者住院日减少,住院费、药费下降,检查费上升。结论脑卒中多模式救治下的临床路径能提升医疗质量和卫生经济学效果。
Objective To explore the ways and improvements of clinical path under multi-modality treatment of stroke and evaluate its medical quality and health economics. Methods (1) From September 2013 to August 2014, hospitalized patients with cerebral infarction and cerebral hemorrhage in neurology department were treated as the traditional treatment group. The patients with the same type of disease in the same period were treated with multimodal treatment. The clinical practice was compared. (2) Inpatients with cerebral infarction (ICD-10: I63) and intracerebral hemorrhage (ICD-10: I61) in the first year after the clinical pathway were implemented as the traditional group to implement clinical pathway for one year and completed the same pathological clinical pathology Hospitalized patients for the clinical pathway group, evaluation of two sets of data. Results In the multimodal treatment group, the clinical pathway of cerebral infarction and intracerebral hemorrhage had a higher rate of entry and completion, and a lower mutation rate. Before and after the implementation of clinical pathology, cerebral infarction and cerebral hemorrhage in patients with reduced hospitalization days, hospital fees, drug costs, examination fees increased. Conclusion The clinical pathways under multimodal treatment of stroke can improve the medical quality and health economics.