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頁籤選單縮合
題名 | 肺癌手術病患臨床路徑之建立=The Build-Up of Clinical Pathway for Surgical Patients of Lung Cancer |
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作者 | 蔡淑芳; | 書刊名 | 榮總護理 |
卷期 | 15:4 1998.12[民87.12] |
頁次 | 頁419-427 |
分類號 | 419.77 |
關鍵詞 | 臨床路徑; 論病例計酬; 照護品質; 個案管理; Clinical pathway; Case payment; Nursing quality; Case management; |
語文 | 中文(Chinese) |
中文摘要 | 為因應醫療給付制度之改變,提高醫療效率及效益、維持醫療照護品質、加強醫 院行政管理,本專案的目的在建立及實施肺癌手術臨床路徑,以便瞭解醫療照護過程及其差 異性,達提升照護品質、縮短住院日數、降低醫療費用。 首先對本院胸腔外科病房肺癌手術病患,查閱回溯性資料,共收集 28 位個案,進行資料分 析,將結果和本科醫師討論,擬訂 12 天為臨床路徑之實施,經過兩週的宣導及一個月的試 行,從 85.11.1 開始實施, 收集 30 位個案,結果達成率僅 63.3%,針對延遲原因進行分 析及討論, 並從 86.3.15 開始再實施, 收集 26 位個案,結果:( 1 )平均住院天數為 12.07 天比實施前縮短 1.82 天,達成率 61.5%。 ( 2 )住院醫療費用每個病患可節省約 兩天之病房費用,治療處理費每個案平均為 13285.2 元,比實施前節省 6111.8 元。 ( 3 )病患滿意度在滿意程度以上者達 95%。結果可提供醫院管理者改善作業型態,作為其它疾 病診療標準規範,推廣臨床路徑於數量多、高危險及高成本病人應用之參考。 |
英文摘要 | In order to coordinate changes in the Payment Delivery System, we have to raise the efficiency and benefits of medical treatment, maintain nursing quality and heighten hospital administration. This study is to build up and put into practice a clinical pathway for surgical patients of lung cancer for better understanding of treatment of nursing processes and differences, and is aiming to heighten the nursing quality along with shorter length of stay and cost containment. The research, firstly made a 28-case traceable data recollection from the previously operative lung cancer patients in the thoracic surgery division. Data were analyzed and discussed with attending doctors, and a 12-day clinical pathway of practicing was planned. Secondly, the pathway was put into practice after two-week's propaganda and one-month probation. 30 cases had been collected since Nov. 11,1996, and the rate of achievement was 63.3%. Then, factors in delay went on analyzed and discussed. And thirdly, 26 casea were collected when pathway was again carried on practiced since Mar. 15, 1997. Results were as follows: (1) The mean length of stay was 12.07 days, i. e., 1.82 days shortened than before. Achievement rate reached 61.5%. (2)The mean case payment charged 13285.2 yuans with 6111.8 yuans saved, and the mean cost of hospitalization for each patient was two days less, as compared with the pathway put into practice befor. (3) Degree of patient's satisfaction reached a satisfactory index of 95%. Results would be standardized for hospital administrators to improve typological operation and for other diseaseas' treatment, and popularize in clinical pathway as a reference applied to those patients of high volume, high risk, and high cost. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。