DRUGS System Improving the Effects of Clinical Pathways: A Systematic Study
DRUGS System Improving the Effects of Clinical Pathways: A Systematic Study
复制标题
药物系统改善临床路径的效果：一项系统研究
DOI：
10.1007/s10916-015-0400-6
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发表时间：
2016-03
影响因子：
5.3
通讯作者：
Wen, Aidong
中科院分区：
文献类型：
--
作者：
Ma, Lixiazi;Guo, Huning;Wang, Jingwen;Wen, Aidong
本研究旨在评估药物合理使用指南系统（Drugs -supported clinical pathway， CP）在乳腺癌、白内障、腹沟疝、2型糖尿病等临床应用的可行性，该系统的应用能否提高工作效率、医疗安全、降低医院成本。选取4种疾病共1773例（其中纸质临床途径901例，药物支持临床途径872例），收集其人口学和临床资料。评估标准为住院时间、术前住院时间、住院费用、住院期间使用抗生素、非计划手术、并发症和预后。药物支持CP组的中位总LOS比纸质CP组短1 ~ 3天（p< 0.05）。药物支持CP组的总住院费用明显低于纸质CP组。住院期间使用的抗生素，除抗生素种类的选择外，抗生素初始给药时间和给药时间均无统计学差异。在药物支持的临床途径条件下，处方广谱抗生素的比例在纸质组从63.6%下降到34.5% （p< 0.01）。干预后，两组在计划外手术、并发症及预后方面差异无统计学意义。在这项研究中，药物支持的乳腺癌、白内障、腹股沟疝、2型糖尿病的临床路径从纸质系统顺利转移到电子系统，并在医院层面带来了好处。
The aim of the study is to assess the feasibility of Drugs Rational Usage Guideline System (DRUGS)-supported clinical pathway (CP) for breast carcinoma, cataract, inguinal hernia and 2-diabetes mellitus whether the application of such a system could improve work efficiency, medical safety, and decrease hospital cost. Four kinds of diseases which included 1773 cases (where 901 cases using paper-based clinical pathways and 872 cases using DRUGS-supported clinical pathways) were selected and their demographic and clinical data were collected. The evaluation criteria were length of stay, preoperative length of stay, hospital cost, antibiotics prescribed during hospitalization, unscheduled surgery, complications and prognosis. The median total LOS was 1 to 3 days shorter in the DRUGS-supported CP group as compared to the Paper-based CP group for all types (p< 0.05). Totel hospital cost decreased significantly in the DRUGS-supported CP group than that in Paper-based CP group. About antibiotics prescribed during hospitalization, there were no statistically differences in the time of initial dose of antibiotic and the duration of administration except the choice of antibiotic categories. The proportion of DRUGS-supported clinical pathway conditions where a broad-spectrum antibiotic was prescribed decreased from 63.6 to 34.5 % (p< 0.01) in the Paper-based group. While after the intervention, the differences were statistically not significant in unscheduled surgery, complications and prognosis. In this study, DRUGS-supported clinical pathway for breast carcinoma, cataract, inguinal hernia, 2-diabetes mellitus was smoothly shifted from a paper-based to an electronic system, and confer benefits at the hospital level.
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影响因子：
3
作者：
R. Grol
通讯作者：
R. Grol
影响因子：
39.2
作者：
PEARSON, SD;GOULARTFISHER, D;LEE, TH
通讯作者：
LEE, TH
影响因子：
3.7
作者：
Yang Z;Zhao P;Wang J;Tong L;Cao J;Tian Y;Yao Z;Wang J;Zhu Y;Jia Y;Wen A
通讯作者：
Wen A
影响因子：
2.6
作者：
Panella, M;Marchisio, S;Di Stanislao, F
通讯作者：
Di Stanislao, F
DOI：
10.1016/j.jamcollsurg.2008.01.023
发表时间：
2008-07
影响因子：
5.2
作者：
G. Whitman;Vincent Cowell;Kristen Parris;Patricia McCullough;T. Howard;J. Gaughan;D. Karavite;Madolin Kennedy;J. McInerney;C. Rose
通讯作者：
G. Whitman;Vincent Cowell;Kristen Parris;Patricia McCullough;T. Howard;J. Gaughan;D. Karavite;Madolin Kennedy;J. McInerney;C. Rose