摘要
目的研究上海某三甲专科医院心内科代表性病种（心律失常、冠心病）的无效入院及无效住院日比率,探讨发生原因及降低无效入院和无效住院日的方法方法随机抽取2个病种1182份病案,利用AEP入院和住院日适宜性评价标准进行回顾性评价。结果2个病种入院无效率为7.11%，住院日无效率为18.41%。发生无效入院的主要原因是低水平诊疗；发生无效住院日的主要原因为超常规续观、出院不及时、等待手术、等待检查。经Logistic回归分析,住院期间是否进行介入治疗、住院天数、住院日是否为休息日、住院日所处诊疗阶段对无效住院日发生与否有显著影响。结论通过加快医院信息化建设,推进临床路径管理,优化医院内部服务流程和资源配置,缩短候检及出检时间；制定合理的绩效考核指标,完善内部不良事件报告和预警机制,可有效减少无效住院日的发生。
Objectives To study the rate of the inappropriate admission and hospitalization days in the Department of Cardiology of a tertiary hospital in Shanghai, identify the major factors of incidence. Methods： 1182 sampled cases diagnosed with arrhythmia and coronary heart disease were randomized. We used AEP appropriate admission and hospitalization day criteria to evaluate retrospectively.Results： The proportion of inappropriate admission was 7.11% in arrhythmia and coronary heart disease samples, while the proportion of inappropriate hospitalization days was 18.41% as well.The main causes of inappropriate admission was the low level of diagnosis and treatment. The major causes of inappropriate hospitalization days were abnormal continued observation, delayed discharge, waiting for surgery and waiting for examination. Logistic regression analysis illustrated that the factors of whether the patients having the intervention treatment, the hospitalization days, hospitalization days for the rest days, stage of diagnosis and treatment in hospital have a significant impact on the occurrence of inappropriate hospitalization days. Conclusions： Inappropriate hospitalization days can be reduced by accelerate the construction of hospital information system, promote the clinical path management, optimize the internal service flow and resource, shorten the waiting time, formulate reasonable performance assessment measures, improve and establish internal adverse events reporting and early warning mechanism.
出处
《中国心血管病研究》
CAS
2016年第3期272-276,共5页
Chinese Journal of Cardiovascular Research
