The Effect of Clinical Pathway Optimization Management Based on DIP on Medical Expenses of Patients With AMI
Objective To explore the effect of clinical pathway optimization management based on diagnosis-intervention packet (DIP) on the medical expenses of patients with acute myocardial infarction (AMI). Methods The clinical data of AMI patients treated and discharged from the First People's Hospital of Zhaoqing from 2021 to 2023 were retrospectively analyzed. According to the medical insurance policy,single-disease payment was adopted from January to December 2021,DIP payment from January 2022,the clinical pathway management was implemented from January 2021,and the optimized management of clinical pathways based on DIP disease was implemented from January 2023. A total of 1425 clinical medical records were obtained,including 455 in 2021,490 in 2022 and 480 in 2023. The medical expenses of patients with AMI from 2021 to 2023 were analyzed. The completion rate and variation rate of clinical pathways in patients with AMI from 2021 to 2023 were analyzed. Results From 2021 to 2023,the hospitalization medical cost of patients with AMI fluctuated. The hospitalization medical expenses of AMI patients fluctuated from 2021 to 2023. The comprehensive medical service fee,diagnosis fee,treatment fee,operation fee,consumables fee,drug fee,other expenses and total expenses in 2022 and 2023 were lower than those in 2021,the differences were statistically significant (P<0.05). The comprehensive medical service fee,treatment fee,surgery fee,consumables fee,drug fee and total cost in 2023 were lower than those in 2022,the differences were statistically significant (P<0.05). The clinical pathway completion rate,clinical pathway variation rate,length of stay variation rate and hospitalization cost variation rate in 2023 were 93.54％,6.46％,3.12％,and 3.96％,respectively,and 80.61％,19.39％,8.16％,and 12.04％ in 2022,respectively,and 74.94％,25.05％,13.93％ and 14.95％ in 2021. The clinical pathway completion rate in 2023 was higher than that in 2022 and 2021,while the clinical pathway variation rate,length of stay variation rate and hospitalization cost variation rate were lower than those in 2022 and 2021,the differences were statistically significant (P<0.05). The clinical pathway completion rate in 2022 was higher than that in 2021,while clinical pathway variation rate and length of stay variation rate were lower than that in 2021,the differences were statistically significant (P<0.05). There was no statistical significance in the hospitalization cost variation rate in 2022 compared with 2021 (P>0.05). Conclusion The optimized management of clinical pathways based on DIP diseases in patients with AMI during hospitalization can reduce the medical costs and shorten the length of hospital stay,improve the clinical pathway completion rate,reduce the mutation rate,and avoid excessive hospitalization medical costs.
万方数据
维普
