DOI: 10.66106/fnabaf.20260108 ISSN: 3105-8000

DIP支付改革下降低非计划拔管标准化护理路径延续实践研究——基于 2026年 1—6月 80例临床数据的实证分析（Study on Continuous Practice of Standardized Nursing Pathway for Reducing Unplanned Extubation Under DIP Payment Reform — An Empirical Analysis Based on Clinical Data of 80 Cases from January t

陈倩 Qian Chen, 何小蓉 Xiaorong He, 杨倩 Qian Yang, 许红兰 Honglan Xu, 李幻 Huan Li
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Abstract：Objective Against the backdrop of comprehensive deepening of the Diagnosis Intervention Package ( DIP ) payment reform , this study aims to verify the long-term stability and continuous optimization value of the standardized nursing pathway for preventing unplanned extubation ( UEX ) , and quantify its comprehensive impacts on nursing quality , medical insurance costs and patient experience . Methods The six-dimensional standardized nursing pathway established in 2023 was retained and upgraded with information technology and supplementary specialized detailed rules . A total of 80 inpatients with indwelling catheters admitted to a Grade B tertiary hospital from January to June 2026 were enrolled as the research cohort . Four indicators including the incidence of unplanned extubation , average length of stay , additional medical expenditure per UEX case and nursing satisfaction were statistically collected and compared with the baseline data of 342 patients at the initial implementation stage of the pathway in 2023 . Results The incidence of unplanned extubation in the 2026 cohort was 1.25 % ( 1 / 80 ) , a decrease of 0.5 percentage points compared with the 2023 baseline ; the average length of stay was ( 8.42 ± 1.87 ) days , 0.51 days shorter than the baseline ; the additional medical expenditure per UEX case was ( 376.4 ± 142.6 ) RMB , down by 24.4 % versus the baseline ; the nursing satisfaction rate reached 98.75 % ( 79 / 80 ) , an increase of 0.8 percentage points relative to the baseline . Statistical tests showed statistically significant inter-group differences in average length of stay ( t = 2.174 , P = 0.030 ) and additional medical expenditure ( t = 6.392 , P < 0.001 ) . Conclusion This standardized nursing pathway features long-term replicability and room for continuous optimization . It can effectively consolidate quality improvement outcomes , further reduce excess costs of DIP disease groups , and realize tripartite coordination of medical quality , medical insurance cost control and patient rights and interests . It provides a promotable practical model for nursing practice to adapt to medical insurance payment reform .

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