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Application research on clinical pathway in perioperative period of total knee arthroplasty in prefecture-level three top hospital |
YANG Jian-qi1 OUYANG Ju-xiang2 GONG Jin-chun3 ZHANG Xi-shun1 LIN Miao-jun1 |
1.Department of Joint Surgery,the First People′s Hospital of Foshan City in Guangdong Province,Foshan528000, China;
2.Department of Quality Control,the First People′s Hospital of Foshan City in Guangdong Province,Foshan 528000,China;
3.Department of Traumatology,Chancheng Hospital Affiliated to the First People′s Hospital of Foshan City in Guangdong Province,Foshan528000,China |
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Abstract Objective To explore the application effect of clinical pathway in total knee arthroplasty in prefecture-level three top hospital.Methods Clinical date of 733 patients with severe osteoarthritis who received total knee arthroplasty operation in the First People′s Hospital of Foshan City from March 2008 to March 2016 were analyzed retrospectively and divided into clinical pathway group(n=392,according to the former ministry of Health in 2009 edition of severe knee osteoarthritis clinical pathway treatment intervention)and traditional medicine group(n=341,who were given previous clinical procedures)according whether or not to accept clinical pathway.Hospitalization days before operation, hospitalization days after operation,total hospitalization days,total hospitalization costs,treatment costs,drug costs,inspection costs,cost of materials,incidences of complications,KSS knee function score,VAS knee pain score,patient satisfaction and other indicators were assessed and analysed.Results There was significant difference(P<0.05)between two groups among hospitalization days after operation(t=2.637,P=0.020),total hospitalization days(t=3.688,P=0.000),postoperative complication rate(χ2=9.694,P=0.002),hospitalization days before operation(t=2.879,P=0.007),postoperative KSS score of knee joint(t=7.331,P=0.000),cost of materials(t=2.727,P=0.010),patient satisfaction(t=6.047,P=0.014).There was no significant difference between two groups in total hospitalization costs,treatment costs,drug costs,othercosts and postoperative pain scores(P>0.05).Conclusion The application of clinical pathway in total knee arthroplasty in prefecture-level three top hospital can regulate clinic medical treatment,reduce hospitalization days,reduce complications,improve treatment result and improve patient satisfaction,but can not control hospitalization costs obviously in prefecture-level three top hospital at this stage.
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