Evaluation of the impact of clinical pathway on medical efficiency and medical expenses of patients with two rheumatoid immune disease based on DRG data
10.3760/cma.j.cn431274-20211105-01157
- VernacularTitle:基于DRG数据评价临床路径对风湿免疫科两种疾病医疗效率和医疗费用的影响
- Author:
Hongwei DU
1
;
Xuelian HONG
;
Liuqing WANG
;
Yujie JIANG
;
Li HUA
;
Ni JIN
;
Minhui XU
;
Jiayi GUO
Author Information
1. 浙江大学医学院附属金华医院风湿免疫科，金华 321000
- Keywords:
Critical pathways;
Arthritis, rheumatoid;
Spondylitis, ankylosing;
Fees, medical
- From:
Journal of Chinese Physician
2022;24(9):1331-1334
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of clinical pathway implementation on medical efficiency and medical expenses of patients with two common rheumatic immune diseases " rheumatoid arthritis" and " ankylosing spondylitis" diseases by using diagnosis related group (DRG) related indicators.Methods:The data of patients with two common rheumatic immune diseases " rheumatoid arthritis" and " ankylosing spondylitis" included in the clinical pathway management from January 2017 to December 2019 in the Department of Rheumatology and Immunology of Jinhua Hospital, Zhejiang University School of Medicine were carried out. The impact of clinical pathway implementation on the average hospital stay, average cost and average drug cost of patients with the two diseases were analyzed and compared , so as to evaluate the effect of the implementation of the clinical pathway.Results:From the implementation of clinical pathway in 2017 to 2019, the number of patients admitted and total medical specialty services in the two groups of " rheumatoid arthritis" and " ankylosing spondylitis" increased year by year ( P<0.01). The average length of stay, average cost and average drug cost of patients in the " rheumatoid arthritis" disease group decreased year by year, with statistically significant differences between groups (all P<0.01). The average length of stay in the ankylosing spondylitis group was shortened year by year, and the difference was statistically significant ( P<0.01). Compared with 2017, the average cost in 2018 decreased significantly, and the difference was statistically significant ( P<0.01). There was no significant difference in average cost between 2018 and 2019 ( P>0.05). The average cost in 2018 was significantly higher than that in 2017 ( P<0.05). After analyzing the causes and optimizing the clinical pathway, the average cost in 2019 was significantly lower than that in 2018 ( P<0.01). Conclusions:Through the implementation of clinical pathways and continuous optimization of pathway connotation during use, the diagnosis and treatment efficiency of patients with " rheumatoid arthritis" and " ankylosing spondylitis" can be significantly improved, and medical costs can be reduced, which is in line with the current medical reform needs.
