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頁籤選單縮合
題名 | 經尿道前列腺切除術臨床路徑之成效探討=Outcome of Clinical Pathway for Transurethral Resection of the Prostate |
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作者 | 梁挋; 蘇輕感; 于大雄; | 書刊名 | 中華民國重症醫學雜誌 |
卷期 | 5:2 2003[民92.] |
頁次 | 頁132-142 |
分類號 | 416.275 |
關鍵詞 | 經尿道前列腺切除術; 臨床路徑; 成效探討; Transurethral resection of the prostate; Clinical pathway; Outcome; |
語文 | 中文(Chinese) |
中文摘要 | 本研究目的為建立經尿道前列腺切除術之臨床路徑,並評估病患平均住院天數、平均醫療費用與導尿管留置天數等的實施成效。本研究以臺北某醫學中心為研究場所,將實施臨床路徑組與未實施路徑相同診斷電腦資料庫及病歷的個案做比較,未實施臨床路徑組94人,實施臨床路徑組123人,本研究結果發現實施臨床路徑組,經尿道切除前列腺術病患之平均住院天數為3.8天,比未實施臨床路徑組皆低1.9天(33.3%),平均住院醫療費用為36,305元,比未實施臨床路徑組降低3,709元(9.3%),導尿管留置天數降低0.6天(17.6%),住院醫療費用中顯示診察費、放射診療費用、治療處直、藥費等費用,實施臨床路徑組均顯著下降。在控制年齡、疾病嚴重度及罹患合併症之下,臨床路徑效果也達顯著影響。本研究符合要臨床路徑者佔84.6,經由變異分析得知,病患入院前之病史,會影響住院天數與醫療費用,所以實施前列腺切除手術時,需控制住院前的原有病史。病患實行前列腺切除術後,病症確實改善,並獲得更好的生活品質。 |
英文摘要 | The purposes of the study were: (1) to develop a clinical pathway for the clients with transurethral resection of the prostate (TURP), and (2) to evaluate the outcome of clinical pathway on average length of stay, hospital fee and duration of Foley catheterization. We compared the outcome of the clinical pathway with retrospective data collected prior to implementation. The clinical pathway group was composed of 123 patients, while the retrospective group was composed of 94 patients. After implementation of clinical pathway, the average length of stay decreased by 1.9 days (33.3%) (from 5.7 days to 3.8 days), the average hospital fee decreased by NT$3,709 (9.3%) (from NT$40,014 to NT$36,305), and the duration of Foley catheterization decreased by 0.6 days (17.6%). Fees for medical, radiology, treatment and pharmacy decreased significantly. There were 84.6% patients in compliance with the clinical pathway. After controlling for age, severity of disease and comorbidity, the clinical pathway group had significant effects. From variance analysis, a patient’s past history had significant impact on length of stay and hospital fees. Controlling comorbidity of pre-hospitalization before implementation of transurethral resection of the prostate is critical in patients receiving TURP due to benign prostate hyperplasia. In conclusion, implementation of TURP can improve the symptoms and retain higher quality of life. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。