Clinical pathway management on daytime surgery of adult patients with inguinal hernia

doi:10.3877/cma.j.issn.1674-0793.2019.04.007

Abstract

Abstract:

Objective

To analyze the effect of clinical pathway management on daytime surgery of adult patients with inguinal hernia.

Methods

Based on the application of clinical pathway, one hundred and twenty patients with unilateral inguinal hernia were recruited in Liaocheng People’s Hospital from January 2014 to June 2016, and were divided into clinical pathway group (observation group) with 56 cases and inpatient surgery group (control group) with 64 cases according to patients’ opinion. The length of stay, costs, surgical effect, postoperative complications and cost-effectiveness analysis were compared.

Results

There were no significant differences between the two groups in operation time, blood loss during the operation, or postoperative complications (t=0.397, 0.790, P=0.823, 0.430; χ²=0.250, P=0.617). Compared with the control group, the length of stay and costs were shorter in the observation group (t=10.851, 6.755, both P<0.001), and cost-effects were lower.

Conclusion

The clinical pathway management can significantly reduce the costs of stay, improve the efficiency with minimized medical risk and ensure the medical safety and quality.

Key words: Clinical pathways, Hernia, inguinal, Day care

Hui Xi, Panpan Xie, Wei Zhang, Zhen Wu, Zhaoqing Cui. Clinical pathway management on daytime surgery of adult patients with inguinal hernia[J]. Chinese Archives of General Surgery(Electronic Edition), 2019, 13(04): 287-290.

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References 16

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组别	例数	年龄（岁，±s)	性别（例）		疝分型（例）
组别	例数	年龄（岁，±s)	男	女	Ⅰ	Ⅱ	Ⅲ
观察组	56	52.17±9.64	49	7	5	39	12
对照组	64	53.75±10.13	55	9	7	46	11
统计值	?	t=0.455	χ²=0.063		χ²=0.422
P值	?	0.760	0.802		0.810

组别	例数	年龄（岁，±s)	性别（例）		疝分型（例）
组别	例数	年龄（岁，±s)	男	女	Ⅰ	Ⅱ	Ⅲ
观察组	56	52.17±9.64	49	7	5	39	12
对照组	64	53.75±10.13	55	9	7	46	11
统计值	?	t=0.455	χ²=0.063		χ²=0.422
P值	?	0.760	0.802		0.810

组别	例数	手术时间(min，±s)	术中出血量(ml，±s)	住院时间(d，±s)	住院总费用(元，±s)	术后并发症[例(%)]
组别	例数	手术时间(min，±s)	术中出血量(ml，±s)	住院时间(d，±s)	住院总费用(元，±s)	切口感染	阴囊积液
观察组	56	47.21±5.27	20.13±1.22	1.00±0.00	5 435.46±237.65	5(8.93)	1(1.79)
对照组	64	45.35±6.12	17.62±1.57	4.71±0.48	8 672.21±256.14	6(9.38)	2(3.12)
统计值	?	0.397	0.790	10.851	6.755	0.232^a
P值	?	0.823	0.430	<0.001	<0.001	0.891

组别	例数	手术时间(min，±s)	术中出血量(ml，±s)	住院时间(d，±s)	住院总费用(元，±s)	术后并发症[例(%)]
组别	例数	手术时间(min，±s)	术中出血量(ml，±s)	住院时间(d，±s)	住院总费用(元，±s)	切口感染	阴囊积液
观察组	56	47.21±5.27	20.13±1.22	1.00±0.00	5 435.46±237.65	5(8.93)	1(1.79)
对照组	64	45.35±6.12	17.62±1.57	4.71±0.48	8 672.21±256.14	6(9.38)	2(3.12)
统计值	?	0.397	0.790	10.851	6.755	0.232^a
P值	?	0.823	0.430	<0.001	<0.001	0.891

组别	例数	住院费用(元)	切口感染			阴囊积液
组别	例数	住院费用(元)	例数(%)	社会成本(元)	成本效果比	例数(%)	社会成本(元)	成本效果比
观察组	56	5 435	5(8.93)	29 839.70	5 967.94	1(1.79)	5 534.06	5 534.06
对照组	64	8 672	6(9.38)	57 417.78	9 569.63	2(3.13)	17 904.40	8 952.20

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