本文選題：臨床路徑 + 單病種醫(yī)療質(zhì)量控制�。� 參考：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：通過應(yīng)用衛(wèi)生部《病種質(zhì)量控制標(biāo)準(zhǔn)》的指標(biāo),對樣本醫(yī)院計劃性剖宮產(chǎn)臨床路徑的實施效果進行分析,觀察在現(xiàn)有的臨床路徑管理模式下,是否能控制不規(guī)范臨床診療行為。探索臨床路徑管理模式與單病種質(zhì)量控制有機結(jié)合的可行性和方法。方法：通過文獻研究法和樣本醫(yī)院臨床路徑實施情況資料,了解計劃性剖宮產(chǎn)臨床路徑和該病種醫(yī)療質(zhì)量控制的實施現(xiàn)狀和難點；采用系統(tǒng)隨機抽樣的方法,對照研究實施(觀察組)與未實施(對照組)臨床路徑管理的計劃性剖宮產(chǎn)患者的住院療程、診療合理性、醫(yī)療費用、患者滿意度等相關(guān)指標(biāo)變化,評價實施該病種臨床路徑控制醫(yī)療質(zhì)量的效果,尋找進一步完善臨床路徑的方法；采用SPSS13.0統(tǒng)計軟件包處理數(shù)據(jù),兩組間比較采用t檢驗,計數(shù)資料采用χ2檢驗；將收集到的各類數(shù)據(jù)分類輸入Excel數(shù)據(jù)庫中進行計算,使用SPSS13.0分析軟件對病種醫(yī)療質(zhì)量相關(guān)指標(biāo)進行描述性統(tǒng)計分析。結(jié)果：實施計劃性剖宮產(chǎn)臨床路徑后產(chǎn)婦住院天數(shù)、術(shù)后住院日均明顯縮短,藥費降低而且患者對醫(yī)療質(zhì)量的滿意度提高,社會因素為手術(shù)指征的剖宮產(chǎn)率降低,且觀察組與對照組間比較,差異均有統(tǒng)計學(xué)意義(p0.05)。新生兒窒息率、產(chǎn)后出血發(fā)生率、總住院醫(yī)療費、手術(shù)切口Ⅱ甲愈合率,組間比較差異均無統(tǒng)計學(xué)意義(P0.05)),但兩組指標(biāo)均在控制目標(biāo)范圍內(nèi)。結(jié)論：計劃性剖宮產(chǎn)臨床路徑的實施降低了住院天數(shù)和術(shù)后住院日,相對提高了醫(yī)療服務(wù)效率；患者滿意度提高,在一定程度上改善了醫(yī)患關(guān)系；藥費明顯降低,相對控制了不合理用藥尤其是濫用抗生素的問題；患者及家屬要求的剖宮產(chǎn)手術(shù)比率降低,在一定程度上控制了剖宮產(chǎn)率,提高了產(chǎn)科質(zhì)量。臨床路徑管理模式下能對已經(jīng)較規(guī)范的診療行為起到繼續(xù)督導(dǎo)、控制的作用。進行醫(yī)療質(zhì)量控制還需要注意很多細(xì)節(jié),還有很多地方需要完善,只有有效利用信息系統(tǒng),建立一個便于操作和執(zhí)行的,適合病種特點和符合醫(yī)院實際的,科學(xué)的臨床路徑實施、評價及管理體系,才能真正實現(xiàn)其醫(yī)療質(zhì)量控制和管理的作用。
[Abstract]:Objective: to analyze the effect of clinical route of planned cesarean section in a sample hospital by applying the index of quality control standard of disease species in Ministry of Health, and observe the effect of clinical path management mode. Whether can control nonstandard clinical diagnosis and treatment behavior. To explore the feasibility and method of combining clinical pathway management mode with single disease quality control. Methods: by means of literature research and the data of clinical path implementation in the sample hospital, the present situation and difficulties of clinical route and medical quality control of planned cesarean section were investigated, and the method of systematic random sampling was used. The changes of hospitalization course, rationality of diagnosis and treatment, medical cost and patient satisfaction of planned cesarean section patients with and without clinical path management were studied in the control group and the control group, respectively. To evaluate the effect of implementing the clinical pathway to control the quality of medical treatment, to find a way to further improve the clinical pathway, to use SPSS 13.0 statistical software package to process the data, to compare the data between the two groups by t test, and to use 蠂 2 test to count the data. The collected data were classified into Excel database for calculation, and SPSS 13.0 analysis software was used to analyze the related indexes of medical quality. Results: after the clinical route of planned cesarean section was carried out, the days of hospitalization were significantly shortened, the cost of medicine was reduced, and the patients' satisfaction with the quality of medical treatment was improved, and the rate of cesarean section, which was indicated by social factors, was decreased. The difference between the observation group and the control group was statistically significant (P 0.05). The rate of neonatal asphyxia, the incidence of postpartum hemorrhage, the total hospitalization expenses, the healing rate of operation incision 鈪，

本文編號：1995807