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Influence of Hospitalization Costs,Average Length of Stay and Complication Rate of Clinical Pathwayused for Patients with Colon Cancer

Author: ZhaoJian
Tutor: SongChun
School: Dalian Medical University
Course: Oncology
Keywords: clinical pathway colon cancer average length of stay hospitalization costs complication rate
CLC: R735.35
Type: Master's thesis
Year: 2013
Downloads: 36
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Abstract


Objective:To investigate the influence of clinical pathway used for patients with colon canceron hospitalization costs, average length of stay and complications.Methods:Using the contemporary comparison trials method, for all materials adoptretrospective study.the trial group was composed of the eligible patients of clinicalpathway used for patients with colon cancerand those who used clinical pathwayfromJanuary2012to December in LiaoNing cancer hospital and institute(marked forgroup A).The control group was composed of patients who are eligible but didn’t useclinical pathway from January2012to December in LiaoNing cancer hospital andinstitute(marked as group B).Collecting data of average length of stay,lengthofpreoperative, length of postoperative,hospitalization costs and it’s classifiedsections,complication rate for each care and statistically analyzing the data respectively.Results:Efficiency indicators comparison aspects:The trial group’s average length of stayis15.75±2.76days,and the control group is20.23±6.56days; The trial group’s lengthof preoperative is5.44±2.11days,and the control group is8.02±5.19days;The trial group’s length of postoperative is10.32±1.72days,and the control group is12.21±4.77days,all the three groups of data exist significant difference(P<0.05).Comparison of economic indices:The trial group’s hospitalization costs is38112.61±7394.05yuan,and44071.64±14232.59yuan for the control group;The trialgroup’s Western Medicine cost is12130.96±4079.01yuan,and15304.92±7313.27yuanfor the control group; The trial group’s cost of nursing care is258.73±58.24yuan,and298.82±238.58yuan for the control group; The trial group’s cost of medical tests is837.05±441.13yuan,and1078.13±1346.52yuan for the control group;The trial group’soperation fee is2938.47±1002.81yuan,and3298.69±1378.94yuan for the control group;The trial group’s Check the fees (including ecg, lung function and pathologicexamination, etc.) is1077.78±832.53yuan,and1322.99±1247.80yuan for the controlgroup; The trial group’s anesthetic fee is1566.16±301.75yuan,and1661.23±372.47yuan for the control group; The trial group’s others fee(medical consumables feeisincluded) is14913.74±3514.83yuan,and16359.11±5846.16yuan for the controlgroup,all of groups of data exist significant difference(P<0.05).After furthercomparison showed implement clinical pathway group cost is lower.Comparison of complication:With reference to the internationally acceptedpreoperative risk assessment tool POSSUM series scale in the postoperativecomplications of type is put forward. The classification of Postoperative complicationsand thecases of classifications: group A (clinical pathway group) Bleeding suchcomplications occurred in2cases;6cases of Infection complications;Incisioncomplications in5cases;Anastomotic fistula in3cases; Thrombosis and embolismcomplications in3patients; Colostomy complications in5cases;4cases were intestinalobstruction; Stress ulcer in5cases; Abnormal blood pressure in7cases; Renaldysfunction in3patients;0cases of respiratory failure; Cardiac insufficiency in1case.Group B (the other group) Bleeding complications in3patients;8Infectioncomplications;6cases Incision complications; Anastomotic fistula in3cases;4casesColostomy complications; Thrombosis and embolism complications4cases;5cases ofintestinal obstruction; Stress ulcer in7cases;9cases of abnormal blood pressure; Renaldysfunction in3patients; Respiratory failure in1case; Cardiac insufficiency in2cases.Group A(clinical pathway group) total of44cases of complications. Group B (the othergroup) total55cases of complications.through statistics analysis, P values were allgreater than0.05.There were no significant difference in complications between the clinical pathway group and not.But complication rate was27.00%in clinical pathwaygroup and incidence of complications was33.74%in the other, visible clinical pathwaygroup showed downward trend in the incidence of complications.Conclusions:The application of clinical pathway for patients with colon cancer can significantlyshort average length of stay, improve work efficiency on hospital operations, increasethe utilization rate of health resources; In health economic aspects hospital costsisreduced.Expenses for medicine and health care costsare significantly reduced,theeconomic burden is appropriate reduced. In terms of health effects, the incidence ofcomplications did not see obvious difference, only the trendto reducing.

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CLC: > Medicine, health > Oncology > Gastrointestinal Cancer > Intestinal neoplasms > Colon tumor
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