Applicational Study Of Clinical Pathway In The Therapy Spontaneous Pneumothorax

Spontaneous pneumothorax is a common disease in the thoracic surgery with an occurrence of about 20%, and is also one of the emergent disorders that might lead to death if corresponding treatment could not be performed duly. Etiological survey showed that spontaneous pneumothorax is currently still a very dangerous disease, with progressively elevated morbidity in recent years. In general population, the incidence of primary spontaneous pneumothorax is about 0.009%. At present, surgical operation is still the only effective way to cure spontaneous pneumothorax. Traditional thoracotomy is becoming difficult to be accepted by the patients with spontaneous pneumothorax and the thoracic surgeons, due to its side effects and longer hospitalization. By contrast, minimally invasive surgery, which developed in recent years, altered the treatment strategy of spontaneous pneumothorax. Video-assisted thoracoscopy, as a minimally invasive surgical method that originated from the nineties of last century, has become a gold standard for the treatment of spontaneous pneumothorax. This is because it not only embodied the goodness of surgical operation, but also followed the treatment rules of spontaneous pneumothorax. Currently, reducing the cost of video-assisted thoracoscopy is a practical issue that is needed to be resolved by policy-makers and medical staffs, because higher cost limited its further application. The cost of medical service is affected by multiple factors, of which how to control the cost of diseases is the most complicated. At present, studies on the feasibility about control of the disease cost have come to an agreement, which include guided by disease type, using studying method of evidence-based medicine, and making administration rules suiting our conditions according to the relevant influence factors. As a new mode of modern quality administration of solitary disease, clinical pathway has been gradually gotten attentions from policy-makers and hospital administrators. Currently, administration of clinical pathway is at initial stage, and rare reports involved in the studies on the administration of clinical pathway in the patients with spontaneous pneumothorax. This project will focus on the effects of the quality control mode of clinical pathway administrated in the patients with spontaneous pneumothorax, in order to standardize the process of diagnosis and treatment, reduce the medical cost, shorten the hospitalization period, promote the feasible usage of medical recourses, and improve the patient satisfaction. This study would theoretically support the further application of clinical pathway in the daily clinical activities.Objective:1. To study the effects of clinical pathway administration on the hospital days.2. To study the effects of clinical pathway administration on the hospital cost.3. To study the effects of clinical pathway administration on the satisfy action to nurses.4. To study the effects of clinical pathway administration on acquaintance rate of health education.5. To study the feasibility of clinical pathway administration in order to benefit its further application. MethodsInquiry combined with clinical observation was used. Studies were performed in the 90 patients with spontaneous pneumothorax, who were randomly assigned into the control group and the experiment group, each group consisting of 45 patients. Since admission, the patients in the experiment group would be administrated with clinical pathway in the medical treatment and nursing. The patients in the control group would be treated with traditional method of administration. The clinical data from the patients in these two groups would be collected and analyzed.Results:1. General materials: There is no significant difference in the age, gender, occupation and income between the patients in the experimental group and those in the control group (P>0.05). The patients in these two groups are comparable with each other.2. Comparison of hospital days: The preoperative days in the control group were 2.91±1.50; but they were 2.04±0.88 in the experimental group (P<0.05, versus control group). The postoperative days in the control groups were 8.77±1.79, and they reduced to 6.93±1.40 (P<0.05, versus control group)3. Comparison of hospitalization cost: Compared with those in the control group, the hospitalization cost, nursing cost and the drugs cost decreased significantly in the experimental group (P<0.05).4. Comparison of acquaintance rate of health education: The acquaintance rate of health education in the experimental group was significant higher than that in the control group (P<0.05).5. Satisfaction of the patients: The satisfaction of the patients in the experimental group was significant higher than that in the control group (P<0.05).Conclusions1. In the duration of the treatment of spontaneous pneumothorax, the application of clinical pathway administration could significantly shorten hospitalization period, including preoperative and postoperative time.2. During the course of the treatment of spontaneous pneumothorax, the application of clinical pathway administration could significantly decrease medical cost, including the hospital cost, drug cost and nursing cost.3. The application of clinical pathway administration could significantly increase patients'satisfaction to the physicians and nurses.4. The application of clinical pathway administration could significantly increase the acquaintance rate of health education in the patients.