Study Of The Effect Of Clinical Pathway On Patients Of Type2Diabetes Mellitus In Primary Hospital

Clinical pathway, as a standardized pattern of clinical practice and management,was widely introduced to higher level hospitals in our country for years, reducing medicalcost, saving medical resource, and guarantee the medical quality. However, in primaryhospital, situation may be different. It would be helpful to analyze the effect and varianceof clinical pathway of frequently-occurring diseases in primary hospital.Objective: This study was designed to analyze and evaluate the effect ofclinical pathway on patients of type2diabetes mellitus in primary hospital.Method: A Prospective case-control study was conducted in primary hospital.107patients of type2diabetes mellitus between June2011and February2012in this hospitalwere gathered, and there were27patients among them who entered the clinical pathway,but failed to persist in the end, which we called "variance”. In observation group,40patients were treated with clinical pathway Pilot program developed by the Ministry ofHealth as the guideline. In control group,40patients did not enter the pathway and weretreated according to regular medical mode. hospitalization days, total cost in hospital, fasting plasma glucose in discharge day were compared between the two groups. The datewas processed with Microsoft Excel2000and prism4.0. Statistical methods: Twoindependent sample t-test.Results: Hospitalization days in the observation group was significantly shorter thanin the control group （P<0.001）, total cost in hospital significantly decreased in theobservation group（P<0.001）. The difference of fasting plasma glucose between twogroups was also of statistical significance (p<0.05). Analysis of the variance:19patientsdischarged earlier, possess28.4%of the67patients,17.9%owing to illness controlled andstable, blood glucose in ideal scale, and for the10.5%, they requested discharge.8patientspostponed their discharge,62.5%out of them had unsatisfactory curative effect, and37.5%had more complex condition and more concomitant diseases than others, and weretreated in multiple departments in hospital.Conclusion：In primary hospital, the implementation of clinical pathway in themanagement of type2diabetes mellitus patients contributed to shorten hospitalizationdays, reduce total cost in hospital, avoid medical resource wasting, and could make fastingglucose reach the normal scale earlier. It indicated that clinical pathway is an effectivepattern of medical management, which needs to be learned.