摘要
目的分析孕产妇住院患者特点,了解某市建立孕产妇危急重症定点医院建设实施效果。方法由某三甲医院住院病案首页管理系统中采集2015年1月1日-2020年12月31日期间产科出院患者共计16380例病案信息,将患者按年龄分为4组,按每2年一个时间段对各年龄组转诊来源地、年龄分布、上转患者来源地及年龄分布、手术分级等进行卡方检验;对住院日、住院费用进行对比分析;将病案数据导入DRG管理系统分组器,得出CMI值;将2015年-2020年分3个时间段,对疾病分类及顺位变化进行分析。结果2015年-2020年患者共计16380例,总体上高达95.53%的患者来自于省内;年龄分布上,21岁~30岁及31岁~40岁占比为59.90%和36.69%,合计96.59%。来自二级医院的上转患者占81.65%,31岁以上上转患者占90.24%。手术级别一级和二级手术为主,占93.71%。≤30岁病例组住院日随时间段呈递减趋势,≥31岁病例组住院日随时间段呈递增趋势;各年龄组住院日和费用随年龄增长均呈上升趋势。结论危急重症孕产妇定点医院转诊对其分级诊疗具有较好的政策导向,取得了较满意的效果,对提高三甲医院孕产妇诊疗水平、重塑疾病谱、提高CMI值等具有现实意义,今后还应加强危急重症孕产妇转诊工作,加强住院日、费用等指标控制。
Objective To analyze the characteristics of hospitalized pregnant and lying-in women,and understand the effect of the establishment of a designated hospital for critical and intensive care for pregnant and lying-in women in a city.Methods From January 1,2015 to December 31,2020,16380 discharged patients from the obstetric department(including obstetric ICU)were extracted from the first page record of the medical record system of a third-class hospital.The patients were divided into 4 groups according to their age.Chi-square test was performed on the referral origin,age distribution,referral origin and age distribution,operation grade and so on in each age group.The hospitalization days and hospitalization expenses were compared and analyzed;the medical record data were introduced into the grouper of DRG management system to get the CMI value;the disease classification and sequence changes were analyzed in three time periods from 2015 to 2020.Results There were a total of 16,380 patients from 2015 to 2020,with a total of 95.53% of the patients coming from the province.In terms of age distribution,the percentages of 21-30 and 31-40 years old are 59.90% and 36.69%,totaling 96.59%.81.65% of patients transferred from secondary hospitals accounted for 90.24% of patients over 31 years old.Surgical grade I and II surgery mainly,accounting for 93.71%.The hospitalization days of the≤30-year-old group decreased with the time period,while the hospitalization days of the≥31-year-old group increased with the time period.The hospitalization days and expenses of all age groups showed an upward trend with the increase of age.Conclusion The referral of designated hospitals for critically ill pregnant and lying-in women has a good policy orientation for its graded diagnosis and treatment,and has achieved satisfactory results.It is of practical significance for improving the level of diagnosis and treatment of pregnant and lying-in women in tertiary hospitals,reshaping the spectrum of diseases,and increasing CMI values.The refer
作者
庞宇
钱帮富
成柠
杨建南
Pang Yu;Qian Bangfu;Cheng Ning;Yang Jiannan(The 3rd People's Hospital of Chengdu,Chengdu 610031,Sichuan Province,China;不详)
出处
《中国病案》
2021年第12期47-49,共3页
Chinese Medical Record
基金
国家自然科学基金青年科学基金项目(82000029)。
关键词
孕产妇
分级诊疗
双向转诊
CMI
Pregnant women
Graded diagnosis and treatment
Two-way referral
CMI
