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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/24264
標題: | 臨床路徑一致性評 Conformance Analysis of Clinical Pathway |
作者: | Li-Shan Chen 陳俐珊 |
指導教授: | 周雍強(Yon-Chun Chou) |
關鍵字: | 臨床路徑,流程圖,一致性分析,剖腹生產, Clinical Pathway,Flowchart,Conformance Analysis,Caesarean Section, |
出版年 : | 2011 |
學位: | 碩士 |
摘要: | 在健保支付制度轉變成論病例計酬後,對醫院來說必須嚴格控管在醫療流程中的行為,以減少浪費。導入臨床路徑是目前醫療產業中對醫療品質、醫院資源管理與成本控管有效的方法之一。在過去的文獻中證實,若未確實依照路徑內容執行,將無法達到控管成本的目的。然而,目前研究中多以問卷調查的方式來做為評估執行一致性的方法,而無法從實際產生的資料中得知。
在本研究中將會提出評估臨床路徑一致性的方法。首先,由於目前臨床路徑所採行之表現方式,無法完整表達臨床路徑內容,因此研究中會先探討臨床路徑表示方法,並以重新以流程圖方式表現,以作為本研究之臨床路徑分析格式。其次,研究中會依照醫療步驟的本身的特色,給予每一步驟特定的屬性的。針對每種屬性,本研究提出相對的計算一致性的方式,使每一步驟可對應到符合屬性的評估式。評估結果將可說明目前執行的狀況。在本論文中,我們以剖腹生產臨床路徑作為範例展示。 As changing fee-for-service system to case payment system, hospitals face more pressures than before. Under this circumstance, hospitals have to be strictly controlled behavior in the medical processes to reduce waste. Clinical pathway is one of the effective methods to control the quality of medical, hospital resource and cost. According to the past literature, not well executed clinical pathway may lead to unnecessary waste in the treatment. Therefore, it is necessary to establish a conformance measurement method to evaluate result of clinical pathway. However,current studies mostly provide questionnaire surveys to assess the conformance of clinical pathway, which may have reliability problem in the evaluation. In this research, we will use part of the medical record to build a method, hich can assess the conformance of clinical pathway. First, we will define a unified representation of clinical pathway. In the previous representation provides limitation information in the real medical process. In this research, we will provide a flowchart approach as clinical pathway analysis format. After building a flowchart, based on the characteristic of the step, we will define property to the treatment steps. According to the property, we will build a suitable formula to analyze the conformance of the clinical pathway. With the new method at hand, we analyze caesarean section clinical pathway conformance at a hospital in Taiwan. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/24264 |
全文授權: | 未授權 |
顯示於系所單位: | 工業工程學研究所 |
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