Xiao-Rong Zhou, Xiao-Wei Shan, Li Zheng, Guo Li, Si Liu
Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2018 May 25;30(3):278-281. doi: 10.16250/j.32.1374.2017235.
To evaluate the effect of clinical pathway (CP) on the implementation of advanced schistosomiasis patients with ascites.
Totally 1 129 cases of advanced schistosomiasis patients with ascites but without other complications were selected randomly from the Performance Evaluation and Management System for Medical Treatment of Advanced Schistosomiasis Patients in Hubei Province from year 2011 to 2013. Among the patients, 754 cases were treated by CP (CP group), and 375 cases were treated with traditional methods (NCP group), and the hospitalization days, hospitalization expenses, medicine proportions, treatment outcomes and degrees of satisfaction and health knowledge rates of the two groups were compared. Meanwhile, the variation of CP was calculated.
The average length of hospital days of the CP group and NCP group were (13.85 ± 5.60) d and (17.92 ± 5.80) d, respectively, and the average hospitalization costs of the two groups were (4 699.14 ± 1 520.59) Yuan and (5 692.01 ± 1 616.66) Yuan, respectively, both the differences were statistically significant (both ＜ 0.05). Also the hospitalization cost structures of the two groups were remarkably different, the composition ratios of the inspection fee and accommodation fee in the CP group were lower than those in the NCP group, but the constituent ratios of the examination fee, diagnosis and treatment fee, drug charges and other expenses were higher than those in the NCP group (all < 0.05). The awareness rate of health knowledge in the CP group was higher than that in the NCP group ( < 0.05), but there were no statistically significant differences in the treatment outcome and the degree of satisfaction between the two groups (both > 0.05). The variation rate of CP was 9.02% (68/754).
The implementation of CP can decrease the days of hospital stay and medical expenses, improve the awareness rate on health knowledge of the patients. The CP treatment with low variation rate is applicable to advanced schistosomiasis patients with ascites but without complications.
评价临床路径（CP）对晚期血吸虫病腹水患者治疗的影响。
从湖北省晚期血吸虫病患者医疗绩效评估管理系统中，随机选取2011年至2013年期间1129例晚期血吸虫病腹水且无其他并发症的患者。其中754例采用CP治疗（CP组），375例采用传统方法治疗（非CP组），比较两组患者的住院天数、住院费用、药品比例、治疗效果、满意度及健康知识知晓率。同时，计算CP的变异度。
CP组和非CP组的平均住院天数分别为（13.85±5.60）天和（17.92±5.80）天，两组的平均住院费用分别为（4699.14±1520.59）元和（5692.01±1616.66）元，差异均有统计学意义（均P＜0.05）。两组的住院费用结构也有显著差异，CP组检查费和住宿费的构成比低于非CP组，但检查费、诊疗费、药费及其他费用的构成比高于非CP组（均P＜0.05）。CP组的健康知识知晓率高于非CP组（P＜0.05），但两组的治疗效果和满意度差异无统计学意义（均P＞0.05）。CP的变异率为9.02%（68/754）。
实施CP可减少住院天数和医疗费用，提高患者的健康知识知晓率。变异率低的CP治疗适用于晚期血吸虫病腹水且无并发症的患者。
