摘要
目的通过三预服务闭环管理模式优化床位管理流程,以期提升公立医院床位利用效率与患者服务质量。方法选取骨科、泌尿外科、胸外科、妇科和耳鼻喉科改革前2023年2月1日—2023年10月31日全部出院患者22084例病案信息为对照组,改革后2024年2月1日—2024年10月31日全部出院患者27531例患者病案信息为实验组。对照组采用由各科室二线根据医师开具的住院通知单进行床位管理,并通知患者住院。实验组采用预出院管理、预排床管理、预住院服务管理即三预服务管理进行床位管理。采用t检验比较两组患者时间消耗指数、费用消耗指数、平均住院日、床位使用率、出院人数等床位利用效率指标。结果实验组平均住院日骨科8.38天,妇产科3.57天,耳鼻喉科6.49天,胸外科5.91天,泌尿外科5.16天低于对照组(9.39、4.06、7.18、6.72、5.67)天,差异具有统计学意义,P<0.01。实验组出院人数骨科5773人次,妇产科11362人次,耳鼻喉科1702人次,胸外科2091人次,泌尿外科6603人次高于对照组(3768、10264、1148、1918、4986)人次,差异具有统计学意义,P<0.01。实验组时间消耗指数骨科1.14,妇产科0.87,耳鼻喉科1.30,胸外科0.75,泌尿外科0.97低于对照组(1.20、0.95、1.31、0.82、1.03),差异具有统计学意义,P<0.01。实验组住院患者满意度骨科95.9分,妇产科96.3分,耳鼻喉科96.3分,胸外科96.7分,泌尿外科96.3分高于对照组(95.3、95.5、95.9、95.8、95.7)分,差异具有统计学意义,P<0.01。结论床位管理中心实施三预服务闭环管理模式可有效提升医院床位利用效率,有效减低候床患者院外等候时间,在一定程度上缓解住院难,提升患者就医效率及服务需求。
Objectives This study aims to optimize the bed management process through the three-pre-service closed-loop management model,in order to improve the bed utilization efficiency and patient service quality of public hospitals.Methods Medical record information of all discharged patients(22,084 cases)from the departments of orthopedics,urology,thoracic surgery,gynecology,and otolaryngology between February 1,2023,and October 31,2023,before the reform,was selected as the control group;medical record information of all discharged patients(27,531 cases)from February 1,2024,to October 31,2024,after the reform,was selected as the experimental group.In the control group,bed management was carried out by secondary-level staff in each department based on the admission notices issued by physicians,who then informed patients of their hospital admission.In the experimental group,bed management was conducted through the'three pre-admission services'system,including pre-discharge management,pre-bed allocation management,and pre-admission service management.A t-test was used to compare bed utilization efficiency indicators between the two groups,including time consumption index,cost consumption index,average length of stay,bed occupancy rate,and number of discharges.Results The average length of hospital stay in the experimental group was 8.38 days for orthopedics,3.57 days for obstetrics and gynecology,6.49 days for otolaryngology,5.91 days for thoracic surgery,and 5.16 days for urology,which were lower than those in the control group(9.39,4.06,7.18,6.72,and 5.67 days),and the differences were statistically significant(P<0.01).The number of discharged patients in the experimental group was higher than that in the control group(3768,10264,1148,1918,4986),including 5773 orthopedic patients,11362 obstetrics and gynecology patients,1702 otolaryngology patients,2091 thoracic surgery patients,and 6603 urology patients,with significant differences(P<0.01).The time consumption index of the experimental group was lower than that of the control group(1.20,0.95,1.31,0.82,1.03)in orthopedics,0.87 in obstetrics and gynecology,1.30 in otolaryngology,0.75 in thoracic surgery,and 0.97 in urology,and the differences were statistically significant(P<0.01).The satisfaction of inpatients in the experimental group was higher than that in the control group(95.3,95.5,95.9,95.8,95.7)in orthopedics,96.3,96.3,96.7,and 96.3,respectively(P<0.01).Conclusions The bed management center implements a three-pre-service closed-loop management model to effectively improve the utilization efficiency of hospital beds,effectively reduce the waiting time outside the hospital for patients waiting for beds,alleviate the difficulty of hospitalization to a certain extent,and improve patients'medical efficiency and service needs.
作者
高爱菊
王燕庆
白雪娟
郭慧鑫
路璐
Gao Aiju;Wang Yanqing;Bai Xuejuan;Guo Huixin;Lu Lu(Beijing Chaoyang Hospital,Capital Medical University,Beijing,100020,China;不详)
出处
《中国病案》
2025年第7期27-29,共3页
Chinese Medical Record
关键词
三预服务
全院一张床
流程管理
效率提升
患者体验
Three-pre-service
One bed in the whole hospital
Process management
Efficiency improvement
Patient experience
