临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (10): 931-.doi: 10.3969 j.issn.1000-3606.2014.10.009

• 综合报道 • 上一篇    下一篇

临床路径管理在毛细支气管炎中的应用及评价

尹丽娟,彭东红,杨洋,黄英,代继宏   

  1. 重庆医科大学附属儿童医院呼吸中心( 重庆 400014)
  • 收稿日期:2014-10-15 出版日期:2014-10-15 发布日期:2014-10-15
  • 通讯作者: 彭东红 E-mail:pdhdxy@163.com

Effect of clinical pathway management on pediatric capillary bronchitis

YIN Lijuan, PENG Donghong, YANG Yang, HUANG Ying, DAI Jihong   

  1. Department of Respiratory Center, Children’s Hospital, Chongqing Medical University, Chongqing
    400014, Sichuan, China
  • Received:2014-10-15 Online:2014-10-15 Published:2014-10-15

摘要:  目的 评价毛细支气管炎临床路径的实施效果。方法 选取开展临床路径管理前后的毛细支气管炎住院患儿,对比分析住院日、住院总费用、家属满意度、治愈率、出院后1周再入院率、院内感染率的差异,以及临床路径管理变异情况。结果 共204例患儿符合入选标准,临床路径研究组96例,对照组108例。两组性别,年龄,入院时呼吸、心率、体温、鼻咽分泌物中呼吸道合胞病毒检出率及痰培养检出率的差异均无统计学意义(P>0.05);经临床路径管理后患儿的药物总费用、抗生素费用及平均住院天数均较管理前下降,差异有统计学意义(P均<0.05),而患儿家属满意度、治愈率、出院后1周再入院率及院内感染发生率等,在临床路径管理前后的差异无统计学意义(P均>0.05)。96例研究组入径患儿中,完成49例(51.04%),正性变异43例(44.79%),负性变异4例(4.17%),退出2例(2.08%)。结论 临床路径管理应用于婴幼儿毛细支气管炎,能有效控制和降低医药费用,同时医疗质量及患者满意度得到保障。

Abstract: Objective To evaluate the effect of clinical pathway management on pediatric capillary bronchitis. Methods Infants with capillary bronchitis admitted to our hospital were selected. Several indices were compared between the infants with and without clinical pathway management including hospital stay, costs of hospitalization, satisfaction in parents of children, cure rate, readmission rate one week after discharge, hospital infection and variation in the process of clinical pathway management. Results A total of 204 eligible infants were divided into research group (n=96) and control group (n=108). There were no significant differences in sex, age, respiratory rate, heart rate and temperature, and detection rate of respiratory syncytial virus in nasopharyngeal secretion and sputum culture (P>0.05). Compared with the infants in control group, the total drug costs, the antibiotics costs and the average length of stay were significantly decreased in infants with clinical pathway management (P<0.05). There were no significant differences in such indices as satisfaction in parents of children, cure rate, readmission rate one week after discharge and hospital infection rate between two groups (P>0.05). In research group, 49 infants (51.04%) completed the clinical pathway management. Positive variance was found in 43 infants (44.79%) and negative variance in 4 infants (4.17%). Two infants (2.08%) dropped out. Conclusions For capillary bronchitis in infants, clinical pathway management has an effect on controlling and reducing the medical expenses, and meanwhile improving the medical quality and satisfaction of patients.