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《Chongqing Medicine》 2017-20
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Study on influence of clinical pathway management on physician diagnosis and treatment behaviors

Huang Xiantao;Wu Xueliang;Xue Jun;Tang Xueqin;Pan Limin;Jing Chao;Xi Biao;First Affiliated Hospital of Hebei North University;Zhangjiakou Municipal Fifth Hospital;Hebei Provincial Health and Family Planning Commission;  
Objective To observe the influence of the clinical pathway management intervention on medical service behaviors.Methods The clinical cases data in a grade A class 3hospital of Zhangjiakou City,Hebei Province during 2011-2013 were retrospectively analyzed.The influence of implementing the clinical pathway management on the diagnosis results,medical records writing quality,clinical medication,operation,hospitalization time,medical costs,assisted examination items selection were observed and analyzed.Results The admission and discharge diagnosis coincidence rate and preoperative and postoperative diagnostic coincidence rate of 3diseases entities in the two groups were 100%,the difference had no statistical significance(P0.05);the medical record grade-A rate in the implementing clinical pathway group was significantly higher than that in the non-implementing clinical pathway group,the medical record grade-B rate was significantly lower than that in the non-implementing clinical pathway group,the difference was statistically significant(P0.05);the antibacterial drugs cost and drugs proportion in the implementing clinical pathway group were significantly lower than those in the non-implementing clinical pathway group,the medication proportion within the directory in the implementing clinical pathway group was significantly higher than that in the non-implementing clinical pathway group,the difference was statistically significant(P0.05);the preoperative preparation time in the implementating clinical pathway group was less than that in the non-implementing clinical pathway group,the difference was statistically significant(P0.05),the grade-A healing rate had no significant difference between the two groups(P0.05);the average hospitalization time,total costs,drug costs,laboratory fee and examination fee in the implementing clinical pathway group were lower than those in the non-implementing clinical pathway group,the difference was statistically significant(P0.05);the operation fee,healthy material fee and nursing fee had no statistically significant difference was statistically significant(P0.05).Conclusion Implementing the clinical pathway can standardize the doctor′s diagnosis and treatment behaviors and makes the medical work to develop to be more favorable for patients.
【Fund】: 河北省卫生计生委指令性科研项目(ZL20140325)
【CateGory Index】: R197.323
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