Evaluate of the Clinical Pathway and Investigation of the Influencing Factors
|Course||Social Medicine and Health Management|
|Keywords||clinical pathway influencing factor variation|
Objective:Evaluate the effectiveness of the clinical pathway that piloted in the Affiliated Hospital of Medical collage Qingdao University. Collect the variation cases and the reasons happened during the pilot work. Study both the doctors and the patients about the clinical pathway. Investigate the possible factors influencing the practice of clinical pathway. Probe to find the ways to deal with these factors.Methods:A non-same-time control study was made on the implementing effects of the clinical pathway by compared the patients underwent the clinical pathway (the pilot group) and the patients before the pilot (the control group). All the average of hospital day and the hospital expense of the patients were studied. We made the questionnaire, with which all the medical staff and patients in the pilot sections were investigated. The cases exited the clinical pathway were collected, and the influencing factors were analyzed.Result:The average in-hospital day, the hospital expense and the drug expenses of the patients underwent the clinical pathway were all dropped significantly. The pre-operation time of the cases of the unstable angina、the bladder tumor and the cancer of larynx were all reduced significantly. The time used the antibiotics in patients of the bladder tumor and the cancer of larynx was both reduced significantly. The reasons led to the variations and exit cases include the features of the disease itself, the lack of the connection of clinical departments, the drawbacks during the implementation. The result of the questionnaire showed that the clinical pathway was highly valued by the patients and the doctors. But the lack of the education about the clinical pathway during the pilot work influenced the implementation of the clinical pathway. The factors that may influencing the clinical pathway including the way that the clinical pathway was formulated as well as the differencese of the doctors, the patients and the disease themselves. The understanding level of the participants, the states of the illness, the way the bill was paid, the engagement of the departments, influenced the clinical pathway significantly.Conclusion:The implementing of the clinical pathway brings many positive effects to the medical reform. The clinical pathway could reduce the in-hospital time and in-hospital cost. But the clinical pathway might be influenced by many factors during the implementing. The publicity and education on both the medical staff and the patients of clinical pathway should be paid more attention. The participant criteria should be obeyed strictly. The coordination and cooperation between various departments is the guarantee of the spread and exploitation of the clinical pathway.