[1]林苡竹,梁红梅,刘雅娟.支付改革背景下结肠癌临床路径优化及效果研究[J].卫生经济研究,2024,41(09):38-43.
　LIN Yizhu,LIANG Hongmei,LIU Yajuan.Study on Optimization and Effect of Clinical Pathways for Colon Cancer in the Context of Payment Reform[J].Journal Press of Health Economics Research,2024,41(09):38-43.
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支付改革背景下结肠癌临床路径优化及效果研究

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
41
期数:
2024年09期
页码:
38-43
栏目:
医疗保障
出版日期:
2024-08-29

文章信息/Info

Title:
Study on Optimization and Effect of Clinical Pathways for Colon Cancer in the Context of Payment Reform
作者:
林苡竹1; 梁红梅1; 刘雅娟1; 2
1.上海交通大学医学院附属新华医院，上海 200092
2.上海申康医院发展中心，上海 200041
Author(s):
LIN Yizhu;  LIANG Hongmei;  LIU Yajuan
Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
关键词:
DRG支付改革; 临床路径; 间断时间序列模型
Keywords:
DRG payment reform;  clinical pathway;  interrupted time series model
分类号:
R19
文献标志码:
A
摘要:
目的：总结临床路径优化的做法，评价优化效果，为实现病种临床路径与医保支付制度改革相适应提供经验借鉴。方法：以上海某医院结肠癌根治切除手术临床路径为研究案例，采用间断时间序列模型，评价临床路径优化的效果。结果：临床路径优化对结肠癌根治切除手术患者住院天数、术前住院日、抗菌药费、药占比、诊断费及其他类费用，具有短期或长期向好的趋势效应影响。结论：基于系统化管理体系优化病种临床路径，对诊疗流程标准化、医疗运行效率提升、病种费用结构优化等能够产生短期或长期的正向效应影响，并能够进一步规范临床诊疗行为，进而与医保支付方式改革目标趋同，推动“三医”协同发展和治理，实现价值医疗。
Abstract:
Objective To summarize the practice of clinical pathway optimization, evaluate the effect of optimization, and to provide experience and reference for adapting clinical pathways of diseases to the reform of medical insurance payment system. Methods Taking the clinical pathway for radical resection of colon cancer in a hospital in Shanghai as a case study, the effect of clinical pathway optimization was evaluated using the interrupted time series model. Results Clinical pathway optimization had a short-term or long-term positive trend effect influence on the number of hospital days, preoperative hospital days, antimicrobial drug costs, drug ratio, diagnostic fees and other types of costs of radical resection surgery for colon cancer patients. Conclusion The optimization of the clinical pathway of diseases based on systematic management system can have short-term or long-term positive effects on the standardization of diagnosis and treatment process, improvement of medical operation efficiency, and optimization of disease cost structure, and further standardize clinical diagnosis and treatment behaviors, which will converge with the goal of payment method reform of medical insurance and promote the synergistic development and governance of the "medical service, medication and medical assurance" to realize value-based health care.

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更新日期/Last Update: 2024-08-29