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Klinične poti - uvajanje in naše izkušnje = Clinical pathways - introduction into a daily practice
Dernič, Jani ; Korošec, Simon, 1973- ; Stopar, Robert
Background: In 2004 DRG was implemented in Slovenia as a reimbursement system in health sector. Along with DRG clinical pathways were introduced and there were some incentives to health service ...provider to build clinical pathway (CP)as standard of care for some diseases. In department of Internal medicine we decided to introduce CP for community acquired pneumonia (CAP). Methods: Wecollected data from CP for CAP form and data from hospital database for patients being treated for CAP between March 2003 and February 2004. Analysis of mortality, length of stay between groups with CP and no CP was done. Demographic data, data of coomorbidity, CAP severity, intravenous therapy, andadherence to CP were collected too in CP group. These data were compared with data available in literature. Result: Total number of patients was 191. 78 patients had CP form filled. Mortality in non CP group was 32,7%, in CP group 19,2% overall mortality was 27,2%. Length of stay was in non CP group 9,8 days, in CP group 9,1 day, statistically not significant. Average age was 72,5 years; only 3 patients were less than 50 years old. Average PORT score was 101,1. This group of patients was treated for 3,8 days with intravenous antimicrobials and had 2 additional coded diagnoses. CP form was properly filled in 45 patients. Conclusions: Management of patients with CAP in accordance with CP gave better outcome of the treatment for these patients compared with those who were not treated following CP. Mortality was almost doubled in the non CP group (32.7% versus 19,2%), length of stay was in this group longer (9,8% versus 9,1 days) but statistically not significant. (Abstract truncated at 2000 characters)
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