Research On The Application Effect And Optimization Strategy Of Clinical Pathway In A Third Class Hospital In Anhui Province

Purpose:By analyzing the operation of clinical pathway in a third class hospital in Anhui Province,this study discusses the implementation effect of clinical pathway,combs the problems existing in the current operation of clinical pathway,formulates corresponding measures,puts forward optimization countermeasures,improves the operation quality of pathway,reasonably controls medical expenses and improves patient satisfaction.Methods:Using the method of comparative study,the data related to the general situation and hospitalization expenses of patients were compared,the differences between the clinical pathway group and the control group were discussed,and the effect of pathway application was compared;Comprehensively used the methods of interview,questionnaire and case study to interview the medical staff,patients and heads of management departments who implement the clinical pathway,investigated the satisfaction of patients,summarized the implementation effect of the clinical pathway,found deficiencies,analyzed the causes of problems and explored countermeasures;comprehensively usedχ~2 test,two independent sample t-test,one-way ANOVA,Pearson accumulation correlation analysis,Kruskal-Wallis H test and other methods,with P<0.05 as the difference,which was statistically significant.Results:1.Operation of clinical pathway:since the smooth operation of clinical pathway software,the number of managed diseases and management departments in the hospital have increased year by year,and the management indicators such as entry rate,entry completion rate,variation rate,drug proportion,antibiotic use rate and consumption proportion are generally optimized.The average length of stay and average cost of hospitalization in the pathway group are lower than the average level of the hospital,which shows that the clinical pathway has a good effect in controlling the length of hospitalization and reducing the cost of hospitalization.2.Research results of various diseases.（1）Analysis of hospitalization days:through the analysis of the distribution of hospitalization days of patients in the two groups of various diseases,it can be seen that only the hospitalization days of patients with chronic obstructive pulmonary disease in the pathway group and the control group have no significant difference,and the hospitalization days of patients with other diseases in the pathway group are less than those in the control group;By comparing the average hospitalization expenses of patients with various diseases by hospitalization days,the hospitalization expenses tend to increase with the increase of hospitalization days.（2）Analysis of hospitalization expenses:the comparison of hospitalization expenses between the two groups of patients with various diseases shows that the average total hospitalization expenses of the five disease group are lower than those of the control group.Among them,vaginal delivery in natural parturition（with a decrease of 30.21%）and chronic cholecystitis（with a decrease of 26.45%）decreases significantly,indicating that the clinical pathway has a better effect in controlling the hospitalization expenses of patients;The analysis of the cost composition ratio of each disease shows that the cost of drugs and consumables accounts for a large proportion,so we should focus on controlling the cost of drugs and consumables.3.The results of satisfaction survey shows that the satisfaction of patients in the pathway group is higher than that in the non clinical pathway group.The interview results confirmes the role of the operation of clinical pathway in ensuring medical safety and improving medical quality,and also shows the problems of unskilled operation and unsmooth system of medical personnel.Conclusion:1.The research on the overall operation and specific diseases of the comprehensive path shows that the average length of stay and average hospitalization cost of patients entering the path are lower than the average level of the hospital,and to varying degrees lower than the control group.The antibiotic use rate,drug proportion and consumption proportion of patients in the clinical path have a downward trend,indicating that the clinical path has a certain effect in improving medical quality and controlling medical expenses.2.There is still room for improvement in the implementation effect of clinical pathway.Implement special activities to reduce the average length of stay,targeted control of hospitalization expenses,and steadily promote the informatization construction of clinical pathway management,so as to improve the operation quality of clinical pathway and realize the level of clinical pathway management.3.Optimizing the clinical pathway management mode continuously,refining the implementation effect of pathway,ensuring medical quality and improving patient satisfaction.