OBJECTIVE To evaluate the effect of clinical pathway (CP) on the implementation of advanced schistosomiasis patients with ascites. METHODS Totally 1 129 cases of advanced schistosomiasis patients with ascites but without other complications were selected randomly from the Performance Evaluation and Management System for Medical Treatment of Advanced Schistosomiasis Patients in Hubei Province from year 2011 to 2013. Among the patients, 754 cases were treated by CP (CP group), and 375 cases were treated with traditional methods (NCP group), and the hospitalization days, hospitalization expenses, medicine proportions, treatment outcomes and degrees of satisfaction and health knowledge rates of the two groups were compared. Meanwhile, the variation of CP was calculated. RESULTS The average length of hospital days of the CP group and NCP group were (13.85 ± 5.60) d and (17.92 ± 5.80) d, respectively, and the average hospitalization costs of the two groups were (4 699.14 ± 1 520.59) Yuan and (5 692.01 ± 1 616.66) Yuan, respectively, both the differences were statistically significant (both P < 0.05). Also the hospitalization cost structures of the two groups were remarkably different, the composition ratios of the inspection fee and accommodation fee in the CP group were lower than those in the NCP group, but the constituent ratios of the examination fee, diagnosis and treatment fee, drug charges and other expenses were higher than those in the NCP group (all P < 0.05). The awareness rate of health knowledge in the CP group was higher than that in the NCP group (P < 0.05), but there were no statistically significant differences in the treatment outcome and the degree of satisfaction between the two groups (both P > 0.05). The variation rate of CP was 9.02% (68/754). CONCLUSIONS The implementation of CP can decrease the days of hospital stay and medical expenses, improve the awareness rate on health knowledge of the patients. The CP treatment with low variation rate is applicable to advanced schistosomiasis patients with ascites but without complications.
OBJECTIVE:To grasp the distribution and epidemiology of confirmed cases of schistosomiasis in Hubei Province, so as to provide the evidence for promoting the prevention and control work.METHODS:The confirmed cases of schistosomiasis in Hubei Province from 2010 to 2014 were epidemiologically investigated, and the prevalence characteristics and main influencing factors were analyzed.RESULTS:A total of 10 102 confirmed cases from 2010 to 2014 were surveyed. There were 1 062 local infected patients, accounting for 10.51% and including 354 repeated infections and 17 newly infected. There were 290 foreigninfected patients, accounting for 2.87%, with 206 repeated infection cases and 84 newly infected. There were 8 750 historical patients, including 2 229 patients who leaked the former schistosomiasis investigations, accounting for 22.06%; 570 patients missed treatment, accounting for 5.64%; 3 640 patients were treated with non-standard therapy, accounting for 36.03%; 2 311 patients were treated with poor medication efficacy, accounting for 22.88%. The multivariate non-conditional Logistic regression, targeting at confirmed cases in 2014, showed that, for the leaking investigations, the potential risk factors included the age, educational level, and latrine renovation (b>0, OR>1), the protective factors were the times of previous treatment, cattle feeding in villager team, and Oncomelania hupensis snails in surroundings (b<0, OR<1); for the treatment-missing, the age, educational level, snails in the surroundings of residence were risk factors (b<0, OR<1); for the substandard treatment, the risk factors included the occupation and snails in the surroundings of residence (b>0, OR>1), and the educational level and snails in the own field were protective factors (b<0, OR<1).CONCLUSIONS:The epidemiological investigation on the confirmed cases of schistosomiasis could grasp the epidemic factors so as to improve the management and carry out the scientific control.