摘要
目的：运用住院日适当性评价修正方案（ N-AEP）分析和评价某综合性三级甲等医院2011—2013年住院日适当性，评估诊疗流程中不适当住院日比例及其成因，预测平均住院日的缩短空间。方法依照卫生部三级综合医院评审数据标准，在18种住院重点疾病中选取某院2011—2013年循环系统、呼吸系统、消化系统、泌尿生殖系统的4种代表疾病：急性心肌梗死、慢性阻塞性肺疾病、消化道出血（无并发症）、肾衰竭共240份病历档案的2926个住院日为样本对象，采用N-AEP进行回顾性评价和研究，利用住院日延迟评判工具（ the delay tool）进行归因分析。结果2926个住院日中337个判断为不适当住院日，住院日不适当比例为11.52%。结论与国内近年来相关研究相比，研究的不适当住院日比例处于中等水平；经过不适当住院日判定后的平均住院日可分别缩短为9.98天、11.78天、10.78天、10.60天；建议医院采取综合管理措施，进一步优化住院日适当性。
Objective To analyze and evaluate the hospitalization appropriateness of a tertiary hospital between 2011 and 2013 through appropriateness evaluation N-protocol （ N-AEP） in order to evaluate the inappropriate hospitalization days pro-portion in diagnosis and treatment process, and to predict the average hospitalization days that should be shorten. Methods Ac-cording to the data reviewed standard of the tertiary hospital, we selected acute myocardial infarction, chronic obstructive pulmo-nary disease, digestive tract hemorrhage （ complications） , and renal failure in eighteen hospitalized key diseases of circulatory system, respiratory system, digestive system, genitourinary system during 2011 to 2013. We took 2 926 hospitalized days from 240 medical records as samples, used N-AEP to carry on the retrospective evaluation and research, and used a delay tool of hos-pitalization evaluation to carry on analysis of attribution. Results Altogether 337 hospitalization days were judged inappropriate-ness, with the inappropriate hospitalization rate 11. 52%. Conclusion The inappropriate hospitalization rate is in a middle level compared with the related records inland China. The average hospitalization days can be respectively shortened to 9. 98 days, 11. 78 days, 10. 78 days, and 10. 60 days. Better hospitalization appropriateness will be achieved if comprehensive measures are carried out in the hospital.
出处
《中国医院统计》
2015年第3期186-189,共4页
Chinese Journal of Hospital Statistics
关键词
住院日适当性评价修正方案
不适当住院日
住院日延迟
Appropriateness evaluation N-protocol（N-AEP）
Inappropriate hospitalization days
The delay of hospital- ization
