Chang P L, Huang S T, Wang T M, Hsieh M L, Tsui K H
Department of Urology, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, ROC.
Br J Urol. 1998 Mar;81(3):394-7. doi: 10.1046/j.1464-410x.1998.00548.x.
To investigate the efficiency of care, length of hospital stay and admission charges after implementing a clinical-care pathway for transurethral prostatectomy (TURP).
Changes in the length of hospital stay and admission charges were identified by comparing a series of 100 patients undergoing TURP and treated after implementing a clinical-care pathway with 100 patients treated by the same physicians before implementation.
After implementing the care pathway, the mean length of hospital stay and admission charges were significantly lower (P < 0.01). The shorter length of stay was caused by a significant reduction (P < 0.05) in patient-related psychological/social delay after implementation. The number of laboratory tests and use of pharmacological agents were also significantly lower (P < 0.001) after implementation, with the decreases in these last variables significantly greater (P < 0.001) among junior physicians.
The advantages of the TURP clinical-care pathway were the shorter hospital stay, arising from reduced patient-related psychological or social delay, and reduced admission charges consequent on the decreased use of laboratory tests and drugs, particularly for patients treated by junior physicians. These results suggest that physicians are likely to modify their management methods to improve efficiency when a clinical path is implemented.
探讨实施经尿道前列腺切除术（TURP）临床护理路径后护理效率、住院时间和住院费用情况。
通过比较实施临床护理路径后接受TURP治疗的100例患者与实施前由相同医生治疗的100例患者，确定住院时间和住院费用的变化。
实施护理路径后，平均住院时间和住院费用显著降低（P < 0.01）。住院时间缩短是由于实施后与患者相关的心理/社会延迟显著减少（P < 0.05）。实施后实验室检查次数和药物使用量也显著降低（P < 0.001），在初级医生中这些变量的下降幅度更大（P < 0.001）。
TURP临床护理路径的优势在于住院时间缩短，这源于与患者相关的心理或社会延迟减少，以及由于实验室检查和药物使用减少导致住院费用降低，特别是对于初级医生治疗的患者。这些结果表明，实施临床路径时医生可能会改变其管理方法以提高效率。
