摘要
目的构建住院患者出院病情Logistic回归模型,并对模型进行评价,初步探讨医源性失误与疾病转归间的关系,为促进医疗质量持续改进提供建议。方法以某院2018年上半年出院患者为研究对象,采用有序Logistic回归建模的方法初步筛选出患者疾病转归的影响因素,并对模型进行拟合优度检验。结果性别、年龄、住院天数、出院科室、医疗差错因素(门诊出院诊断是否一致、入院出院诊断是否一致、手术前后是否一致、是否发生院内感染)、疾病确诊天数等因素进入Lo-gistic回归方程(P<0.05),医源性失误对患者疾病转归产生影响(P<0.05)。结论有序Logistic回归模型对患者疾病转归拟和度较好,从影响因素着手改善医疗质量,减少医源性失误有利于改善患者出院病情。
Objective To construct an ordinal logistic regression model for discharged patients and evaluate its effectiveness and to explore the relationship between iatrogenic errors and discharge outcomes,so as to provide suggestions for promoting the continuous improvement in the quality of medical service. Methods Data of the discharged patients in the hospital in the first half of 2018 were collected to construct the model of ordinal logistic model. The influencing factors of discharge conditions were screened,and then the fitness of the model was tested. Results Factors including gender,age,hospitalization days,iatrogenic error factors ( whether the clinic diagnosis and discharge diagnosis are consistent;whether the admitting diagnosis and discharge diagnosis are consistent;whether the diagnoses before and after surgery are consistent;and whether a nosocomial infection occurs) and disease confirmation days were input into the logistic regression equation ( P<0.05). The results showed that iatrogenic errors have significant impacts on patients' disease conditions when discharged from hospital. Conclusion As the ordinal Logistic regression model is effective in predicting the prognosis of patients,it can help to improve the quality of medical treatment and reduce iatrogenic errors based on influencing factors.
作者
茆广绪
樊春凤
范桂华
毕树英
张彤
MAO Guangxu;FAN Chunfeng;FAN Guihua;BI Shuying;ZHANG Tong(Department of Infection Control,Xinghua People's Hospital,Xinghua 225700)
出处
《解放军医院管理杂志》
2019年第8期753-755,共3页
Hospital Administration Journal of Chinese People's Liberation Army
基金
江苏省现代医院管理研究基金一类资助项目(JSY-1-2018-044)
