摘要
目的通过分析某三甲医院超长住院患者分布情况及影响因素,进一步研究影响超长住院时间的主要因素,并探讨解决方案,为加快病床的周转率,提供临床依据和方案。方法从医院病案系统收集2018年1月-2018年12月医院收治的30230例出院病历首页资料,进行多因素非条件logistic回归分析,观察主要的影响因素。结果神经外科超长住院日患者人数最高,占超长住院患者总数28.70%。在平均住院天数中,康复医学最高,为(97.98±12.43)天。神经外科次均费用较高,为(12.83±2.46)万元。相对住院次数较低组,次数较高组是较低组的1.263倍,不同类型科室、疾病类型、医保付费方式和术前天数都是影响超长住院日的主要因素。结论大型公立医院受科室、疾病类型、付费方式、术前天数、手术等外部因素影响超长住院,应引进科学管理机制,规范诊疗行为,加快诊断相关分组(diagnosis related groups,DRGs)付费的实施,同时建立预警机制。
Objectives To analyze the distribution and influencing factors of super-long hospitalized patients in a third-class hospital,and further explore the main influencing factors affecting the length of hospital stay,and providesolutionsasclinical evidence and protocolsto accelerate the turnover rate of hospital beds.Methods The data of 30230 discharge medical records admitted to hospitals from January 2018 to December 2018 were collected from HIS systemofthe hospital network information center.Variables were included in the regression equation,and multivariate unconditional logistic regression analysis was performed to observe the main influencing factors.Results The number of patients with super-long hospitalization in neurosurgery was the highest,accounting for 28.70%of the total number of super-long hospitalized patients.Among the average hospital stay days,rehabilitation medicine was the highest,and reach to(97.98±12.43)days.The average cost of neurosurgery is higher,which is(12.83±2.46)million yuan.Compared with the lower hospitalization group,the higher frequency group was 1.263 times of the lower group.Different types of departments,disease types,medical insurance payment methods and preoperative days were the main factors affecting the long hospitalization day.Conclusion Large public hospitals are affected by external factors such as department,disease type,payment method,preoperative days,surgery and other external factors.Scientific management mechanism should be introduced to standardize the diagnosis and treatment behavior,accelerate the implementation of DRGs payment,and establish an early warning mechanism.
作者
詹才云
张吉
陈灵杰
ZHAN Caiyun;ZHANG Ji;CHEN Lingjie(Department of Statistics Office,Sanya City People's Hospital,Sanya Hainan 572000,China)
出处
《中国卫生标准管理》
2020年第8期11-13,共3页
China Health Standard Management
关键词
超长住院
特征
影响因素
住院日
医疗服务
平均住院日
super-long hospitalized
characteristics
influencing factors
hospital stay
medical Service
average hospital stay
