Zhongguo cuzhong zazhi (Jan 2024)
脑血管病临床决策支持系统对卒中医疗服务质量关键绩效指标的影响研究 Research on the Influence of Cerebrovascular Disease Clinical Decision Support System on the Key Performance Indicators of Medical Care Quality for Stroke
Abstract
目的 探索脑血管病临床决策支持系统（clinical decision support system，CDSS）对卒中医疗服务质量关键绩效指标改进是否具有积极作用。 方法 回顾性连续纳入首都医科大学附属北京天坛医院血管神经病学2病区应用脑血管病CDSS前（2020年1—11月）住院治疗的缺血性卒中患者作为对照组，应用脑血管病CDSS后（2021年1—11月）收治的缺血性卒中患者作为干预组，比较两组患者的基线特征和缺血性卒中医疗服务质量关键绩效指标，评估脑血管病CDSS对卒中医疗服务质量的影响。 结果 本研究共纳入1331例患者，其中对照组651例，干预组680例。对照组平均年龄为（71.7±11.8）岁，男性490例（75.3%）；干预组平均年龄（72.3±10.2）岁，男性498例（73.2%）。缺血性卒中医疗服务质量关键绩效指标中，干预组入院48 h内不能行走患者进行深静脉血栓预防率（86.3% vs. 65.0%， P＜0.01）、出院时患者抗栓治疗率（98.1% vs. 96.2%，P=0.03）、出院时合并心房颤动的患者抗凝治疗率（70.1% vs. 44.2%，P＜0.01）均高于对照组。 结论 脑血管病CDSS有助于改善缺血性卒中患者的医疗服务质量关键绩效指标。 Abstract: Objective This study aimed to explore whether cerebrovascular disease clinical decision support system (CDSS) could improve the key performance indicators of medical care quality. Methods In our study, ischemic stroke patients hospitalized in Ward 2 of Vascular Neurology, Beijing Tiantan Hospital, Capital Medical University before applying cerebrovascular disease CDSS (January to November 2020) were retrospectively included as the control group. Ischemic stroke patients admitted after the application of CDSS assisted diagnosis and treatment (January to November 2021) were included as the intervention group. The baseline characteristics and key performance indicators of medical care quality for ischemic stroke in these two groups were compared to assess the impact of cerebrovascular disease CDSS on medical care quality of stroke. Results A total of 1331 patients were included in this study, including 651 in the control group and 680 in the intervention group. The mean age of the control group was (71.7±11.8) years, with 490 males (75.3%), and the mean age of the intervention group was (72.3±10.2) years, with 498 males (73.2%). Among the key performance indicators of medical care quality of ischemic stroke, the proportion of patients who were unable to walk within 48 h of admission received deep vein thrombosis prevention (86.3% vs. 65.0%, P<0.01), the rate of patients who were discharged with antithrombotic therapy (98.1% vs. 96.2%, P=0.03), and the rate of patients with atrial fibrillation with anticoagulation therapy (70.1% vs. 44.2%, P<0.01) in the intervention group were higher than those in control group. Conclusions Cerebrovascular disease CDSS can improve the key performance indicators of medical care quality in patients with ischemic stroke.
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