论文部分内容阅读
目的通过研究子宫下段剖宫产病例分型,比较不同分组间的路径实施关键因素住院天数、住院费用间差异,为医院临床路径管理提供思路。方法回顾性查阅某院2015年6月1日-2016年5月31日共2820例子宫下段剖宫产住院患者,应用计算机初筛结合专家病案复判确定分型,分析不同病例分型组间各指标差异。结果 2820例住院患者单纯妊娠仅占1.31%,有妊娠合并症及并发症者占98.69%,病例分型的A型(单纯普通型)1155例、B型(单纯急症型)920例、C型(复杂疑难型)392例、D型(复杂危重型)353例。方差分析提示各组在住院天数(F值270.337)和住院费用间(F值248.167)有差异有统计学意义(P<0.01),进一步组间两两比较提示A、B型均与C、D型在住院天数、住院费用上差异有统计学意义(P<0.01)。A、B型占比73.6%,且两组在住院费用上差异无统计学意义。结论医院可以病例分型为基础制定路径表单、实施路径和质量评价工作,为医保支付改革做准备。
Objective To study the classification of cases of cesarean section in the lower uterine segment, and to compare the differences in hospitalization days and hospitalization costs between different subgroups of pathways, so as to provide ideas for the clinical path management in hospitals. Methods A retrospective review of a hospital from June 1, 2015 to May 31, 2016 a total of 2820 cases of cesarean section in patients with lower uterine inpatients, the application of computer screening combined with expert medical records to determine the type of re-sentence, analysis of different case-type groups Differences between the indicators. Results 2820 inpatients with simple pregnancy accounted for only 1.31%, with pregnancy complications and complications accounted for 98.69%, 1155 cases of type A (plain ordinary type), 920 cases of type B (simple acute type), type C (Complex difficult type) 392 cases, D type (complex critical type) 353 cases. Analysis of variance showed that there was a significant difference (P <0.01) between the days of hospitalization (F value 270.337) and hospitalization costs (F value 248.167), further comparisons between groups A and B were all associated with C, D Type of hospital stay in hospital costs were significantly different (P <0.01). A, B accounted for 73.6%, and there was no significant difference in hospitalization costs between the two groups. Conclusion The hospital can formulate route forms based on case classification, implement the path and quality evaluation, and prepare for the medical insurance reform.