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目的探讨临床路径关于变异来源不同因素的分类方法,从而更好为变异质量控制提供方法。方法通过我院消化科2年多临床路径试点工作的研究,分析总结了临床路径关于变异来源不同因素的分类方法,结合消化内科临床路径病例并和传统的分类方法进行比较分析,观察两种方法优劣。结果新的分类方法提出将变异来源不同因素分为医院因素、医师因素、患者因素以及疾病因素等四种。结果显示:疾病因素变异比例为35%,患者因素33%,医师因素24%,医院因素8%。其中可控制变异57%、不可控变异43%。按传统变异来源的分类方法显示医院因素7%、患者因素71%、医师因素22%,但可控制变异和不可控制无法分类。结论临床路径关于变异来源不同因素新分类方法能使可控制变异统计准确,因此更有效、更切实可行,对临床路径变异情况分析提高供了新的理论依据,对临床变异研究管理有一定的积极意义,在以后路径变异分析研究中可以推广使用。
OBJECTIVE: To investigate the classification of clinical pathways related to different sources of variation so as to provide better methods for quality control of variation. Methods Through two years of clinical trails in our department of Gastroenterology pilot study, analysis of clinical pathological classification of different sources of variation on the method, combined with clinical pathological cases of digestive medicine and traditional classification methods were compared and observed two methods Pros and cons. Results The new classification method proposed to divide the different sources of variation sources into four types: hospital factors, physician factors, patient factors and disease factors. The results showed that the proportion of disease factors variation was 35%, patient factors 33%, physician factors 24%, hospital factors 8%. Among them, 57% of controllable variation and 43% of uncontrollable variation. According to the classification method of traditional variation sources, 7% of hospital factors, 71% of patient factors and 22% of physician factors are displayed, but controllable variation and uncontrollable classification can not be classified. Conclusions Clinical Pathways The new classification method based on different factors of variation sources can make the controllable variation statistics more accurate, so it is more effective and feasible. It provides a new theoretical basis for the analysis and improvement of clinical pathological changes, and has a certain positive effect on clinical variation research and management Meaning, in the future path analysis of variation can be used to promote research.