Implementation effect of clinical pharmacist's participation in the anesthesia clinical pathway for joint replacement surgery in the DRGs payment system
Objective To observe the effect of clinical pharmacists'participation in the anesthesia clinical pathway for joint replacement surgery in the disease diagnosis related groups(DRGs)payment system.Methods This study collected data on patients who underwent joint replacement surgery in the orthopedics department of the China Emergency General Hospital from January to December 2022.Patients from January to June 2022 were set as the control group,and patients treated under the DRGs model with the anesthesia clinical pathway from July to December 2022 were set as the observation group.The con-trol group received standard treatment without intervention,while the observation group received optimized intervention by clinical pharmacists and physicians from admission evaluation,preoperative evaluation,intraoperative evaluation to postopera-tive evaluation.Results A total of 164 patients were included,including 80 patients in the control group and 84 patients in the observation group.In the control group,the cost of anesthesia drugs was(1670.75±579.50)yuan,the total hospitalization cost was(102 861.21±33 521.16)yuan,the total drug cost was(8110.25±3879.97)yuan.The observation group's anesthe-sia cost was(1439.82±520.15)yuan,total hospitalization cost was(74 517.92±31 801.02)yuan,and total drug cost was(6665.42±4957.92)yuan,lower than the control group with statistical significance(P<0.05).The cost of anesthesia was(3423.75±1022.23)yuan in control group and(3632.89±1380.86)yuan in observation group,with no statistical signifi-cance(P>0.05).Preoperative visual analogue scale(VAS)score was(3.31±1.28)in the control group and(1.96±0.84)in the observation group;the postoperative day 2 VAS score was(2.13±0.75)in the control group and(1.73±0.59)in the ob-servation group,significantly lower in the observation group,with statistical significance(P<0.05).The length of hospitaliza-tion was(9.29±5.81)d in the control group and(11.76±6.50)d in the observation group,and the difference was statistically significant(P<0.05).Conclusion Under the DRGs payment system,clinical pharmacists'participation in the implementation of the anesthesia clinical pathway for joint replacement surgery effectively reduces preoperative and postoperative day 2 VAS scores,anesthesia drug costs,total hospitalization costs,and total drug costs on the basis of ensuring the safety and efficacy of clinical treatment.
diagnosis related groupsclinical pharmacistartificial joint replacement surgeryanesthesiaclinical pathway
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