综合医院单病种过程质量及其影响因素分析

目的 分析上海市浦东新区区属公立综合医院6个单病种的医疗规范性、治疗有效性、住院天数与医疗费用以及有关影响因素。 方法 按照国家卫生计生委单病种控制和临床路径要求，对浦东新区7所区属公立综合医院的肺炎、急性心梗死、心力衰竭、2型糖尿病、急性单纯性阑尾炎、计划性剖宫产等6个病种进行病案评价。 结果 (1)6个单病种的医疗规范率总体为40.94%，治疗有效率（治愈或好转率）总体为96.84%。（2）平均住院日为2型糖尿病最长，急性阑尾炎最短；医疗费用最高为急性心梗，最低为急性阑尾炎；此外，遵循单病种质量控制或临床路径要求可降低部分疾病的住院天数及住院费用。 结论 浦东新区卫生行政部门和医院应进一步加强病种质量控制管理，提高医疗质量。

Analysis of the Process Quality of Single Disease and its Influence Factors in Public Comprehensive Hospitals

Objective To analyze the medical standardization, treatment effectiveness, duration of stay and medical cost of 6 diseases and the influence factors in public comprehensive hospitals in Pudong New Area in Shanghai City. Methods Doing medical record evaluation on pneumonia, acute heart infarction, heart failure, type-2 diabetes, acute appendicitis and planned caesarean section in 7 public comprehensive hospitals in Pudong New Area in Shanghai City according to the requirements of the control of single diseases and clinical pathway issued by National Health and Family Planning Commission. Results (1)The total proportion of norm treatment of six diseases was 40.94%, and the proportion of effective treatment was 96.84%. (2)The average hospital stay of patients of type-2 diabetes was the longest, while the acute appendicitis was the shortest. The expense of AMI was the most, while acute appendicitis was the least. The compliance with quality control guidelines for specific diseases or Clinical Pathway could reduce duration of stay and medical costs of inpatients of some diseases. Conclusion Health administrative departments and hospitals in Pudong New Area should strengthen the management of quality control to improve the medical quality.