持續醫療品質改善之實務探討－以腹腔鏡子宮外孕手術之臨床路徑為例

Continuous Quality Improvement in a Regional Hospital-An Evaluation of a Clinical Pathway of Laparoscopic Surgery for Ectopic Pregnancy

黃莉蓉(Li-Jung Huang) ； 徐美華(Mei-Hua Hsu) ； 黃實宏(Shih-Horng Huang)

《醫務管理期刊》 8卷1期 (2007/03) Pp. 39-50

https://doi.org/10.6174/JHM2007.8(1).39

摘要

Objectives: This study demonstrated to control medical cost and to reduce the variance occurrence by executing process-monitoring in a clinical pathway.
Methods: An example for laparoscopic surgery for ectopic pregnancy. The data over 6 month period were collected before and after introduction of process-monitoring. They were statistically analyzed by SPSS 10.0 Software.
Results: The results of outpatient service showed a significant difference in standard deviation (SD) for diagnosis fees and ward fees after process-monitoring is implemented (p＜0.05). In emergency service, the average numbers of X-ray fees, Laboratory fees, drug fees and total medical expense were significantly lower than the value observed before performing process-monitoring (p＜0.05). The SD of anesthesia fees and special materials fees were statistically lower (p＜0.05) which suggest smaller variances.
Conclusions: In this study, process-monitoring can control medical cost effectively and reduce the variance occurrence.

關鍵字

臨床路徑 ； 效益分析 ； 腹腔鏡子宮外孕手術

並列摘要

Objectives: This study demonstrated to control medical cost and to reduce the variance occurrence by executing process-monitoring in a clinical pathway.
Methods: An example for laparoscopic surgery for ectopic pregnancy. The data over 6 month period were collected before and after introduction of process-monitoring. They were statistically analyzed by SPSS 10.0 Software.
Results: The results of outpatient service showed a significant difference in standard deviation (SD) for diagnosis fees and ward fees after process-monitoring is implemented (p＜0.05). In emergency service, the average numbers of X-ray fees, Laboratory fees, drug fees and total medical expense were significantly lower than the value observed before performing process-monitoring (p＜0.05). The SD of anesthesia fees and special materials fees were statistically lower (p＜0.05) which suggest smaller variances.
Conclusions: In this study, process-monitoring can control medical cost effectively and reduce the variance occurrence.

並列關鍵字

Clinical Pathway ； Effectiveness Analysis ； Laparoscopic Surgery for Ectopic Pregnancy

參考文獻

李玉春、楊志良主編(1993)。健康保險。台北:巨流圖書公司。

朱樹勳(2000)。臨床路徑－理論與實務。台北:翰蘆圖書出版公司。

臨床路徑

Nelson, S.P.(1995).Critical pathway at University of Iowa Hospital and Clinics.American Journal Health-syst Pharm.52,1058.

Lindstrom, C.C.,Laird, J.,Soscia, J.(1995).High quality and lower cost: they can coexist.Seminars for Nurse Managers.3(3),133-136.