老年性白内障日间手术临床路径模式效果分析

目的 借鉴国内外日间手术管理经验，在医药分开综合改革的背景下，探索实施老年白内障日间手术临床路径新模式。方法 对首都医科大学附属北京同仁医院2010年（临床路径实施前）、2013年（临床路径实施后）和2016年（日间手术临床路径模式开展后）老年性白内障治疗人均费用、平均住院日、术后感染率进行比较。结果 实施老年白内障日间手术临床路径新模式，平均住院日缩短，人均治疗费用降低，且差异均有统计学意义（P>0.05）。2010年、2013年、2016年的手术感染率都较低，差异无统计学意义（P>0.05）。结论 在保障医疗质量的前提下，老年性白内障日间手术临床路径新模式的实施，不仅提高医院和科室的经济效益，为政府节约医疗资源,而且还能降低患者的治疗费用，提高患者满意度。

Effect Analysis of Clinical Pathway of Day Surgery for Senile Cataract

Objective To learn from experience of day surgery management at home and abroad, and to explore a new approach for Clinical Pathway of day surgery for senile cataract under the background of the comprehensive reform of medical & drug separation. Method Comparing the average cost per day, average length of stay and postoperative infection rate of senile cataract in 2010 (before the implementation of Clinical Pathway), 2013 (after the implementation of Clinical Pathway), and 2016 (after the implementation of Clinical Pathway of day surgery) in Beijing Tongren Hospital Affiliated to Capital Medical University. Result The new model of Clinical Pathway of day surgery for senile cataract surgery is achieved, the average length of stay is shortened, and the treatment cost per capita is decreased. The differences are statistically significant. The rate of surgical infection in 2010, 2013 and 2016 is low and the difference among them is not statistically significant. Conclusion On the premise of ensuring medical quality, the implementation of the new model of Clinical Pathway of day surgery for senile cataract surgery not only improves the economic benefits of hospital and department, and saves the medical resources for the government, but also reduces the cost of patients, and makes them feel achieved during the consultation.