摘要
目的探讨儿童社区获得性肺炎(community acquired pneumonia,CAP)诊治中实施信息化单病种质量管理的效果。方法将厦门大学附属第一医院2020年1月—2023年12月诊治的968例CAP患儿纳入研究。根据单病种质量管理实施情况,将2020年1月—2021年12月收治的433例患儿设为实施前,将2022年1月—2023年12月诊治的535例患儿设为实施后。实施前基于儿童CAP进行常规诊治管理,实施后则通过信息化建立单病种全闭环管理系统,信息化手段加强单病种质量管理。比较实施前后患儿的平均住院天数、住院费用及药品费用、ICU入住率、病原学送检率、抗菌药应用合理性。结果实施后,CAP患儿平均住院天数、抗菌药疗程、住院费用、药品费用分别为(5.28±0.74)d、(4.22±0.30)d、(6678.30±271.36)元、(793.68±26.39)元,均低于实施前的(5.63±1.07)d、(5.03±0.71)d、(7053.56±244.62)元、(1415.26±85.56)元,差异有统计学意义(P<0.05)。实施后,病原学送检率、抗菌药合理应用率、呼吸支持治疗率、入院首次氧合评估率、初始药物治疗72 h病情评估率、病原学再检查率、入院≤4 h首剂抗菌药应用率及出院健康宣教率分别为94.77%、95.51%、48.97%、95.89%、97.01%、92.52%、98.69%、98.50%,均高于实施前85.45%、83.60%、32.79%、87.53%、89.38%、79.91%、91.22%、89.14%,差异有统计学意义(P<0.05)。实施后ICU入住率为6.17%,低于实施前的10.62%,差异有统计学意义(P<0.05)。结论利用信息化手段对儿童CAP开展单病种质量管理,有助于实现规范临床诊疗、保障医疗安全,减轻患者负担,促进医疗卫生资源的合理化应用。
Objective To explore the effectiveness of implementing information-based single disease quality management in the diagnosis and treatment of community acquired pneumonia(CAP)in children.Methods A total of 968 children with CAP diagnosed and treated from January 2020 to December 2023,in the First Affiliated Hospital of Xiamen University were included in the study.According to the implementation of single disease quality management,433 patients admitted from January 2020 to December 2021 were set as before the implementation,and 535 patients treated from January 2022 to December 2023 were set as after the implementation.Before the implementation,routine diagnosis and treatment management was carried out based on children′s CAP.After the implementation,a full-closed-loop management system for single diseases was established through information technology to strengthen the quality management of single diseases.The average hospitalization days,hospitalization costs and drug costs of children before and after the implementation were compared and analyzed,and the ICU occupancy rate,etiology inspection rate and antimicrobial application rationality were mastered.Results After implementation,the average length of hospital stay,duration of antibiotic treatment,hospitalization costs,and drug costs for CAP patients were(5.28±0.74)days,(4.22±0.30)days,(6678.30±271.36)yuan,and(793.68±26.39)yuan,respectively,which were lower than those before implementation(5.63±1.07)days,(5.03±0.71)days,(7053.56±244.62)yuan,and(1415.26±85.56)yuan,respectively,the differences were statistically significant(P<0.05).After implementation,the pathogen testing rate,rational use of antibiotics,respiratory support therapy rate,first admission oxygenation assessment rate,initial treatment 72 hour disease assessment rate,pathogen re examination rate,first dose of antibiotics application rate within 4 hours of admission,and discharge health education rate were 94.77%,95.51%,48.97%,95.89%,97.01%,92.52%,98.69%,and 98.50%,respectively,all higher than before implementation,85.45%,83.60%,32.79%,87.53%,89.38%,79.91%,91.22%,and 89.14%,the differences were statistically significant(P<0.05).The ICU occupancy rate after implementation was 6.17%,lower than the pre implementation rate of 10.62%,and the difference was statistically significant(P<0.05).Conclusion It is helpful to standardize clinical diagnosis and treatment,ensure medical safety,reduce the burden of patients,and promote the rational application of medical and health resources to carry out single disease quality management of children′s CAP by means of information technology.
作者
杨晓晶
庄良金
YANG Xiaojing;ZHUANG Liangjin(Department of Pediatrics,the First Affiliated Hospital of Xiamen University,School of Medicine,Xiamen University,Xiamen Fujian 361003,China;Department of Medical Affairs and Communities,the First Affiliated Hospital of Xiamen University,School of Medicine,Xiamen University,Xiamen Fujian 361003,China)
出处
《中国卫生标准管理》
2025年第10期60-63,共4页
China Health Standard Management
基金
国家卫生健康委医院管理研究所2022年医疗质量循证管理持续改进研究项目(YLZLXZ22K026)
福建中医药大学校管科研课题(XB2023158)。
关键词
儿童社区获得性肺炎
信息化
单病种质量管理
关键质控指标
治疗费用
医疗卫生资源
children community acquired pneumonia
informatization
single disease quality management
key quality control indicators
treatment cost
medical and health resources
