摘要
目的分析骨科住院患者未手术出院的原因,并提出相应的对策和干预措施,以期减少患者未手术出院率,提高科室运行效率。方法选取2020年1—12月收住于骨科的未手术出院患者为研究对象,通过医院电子病历系统的首页数据提取相关资料,并查阅病历明确患者未手术出院的原因,对相关原因进行回顾性分析。结果(1)2020年骨科未手术出院患者为1335例,占全部出院患者的21.03%;(2)未手术出院的原因主要为:保守治疗、并发症、骨科肿瘤术后的后续化学治疗或抗骨质疏松治疗、术前准备不充分;(3)未手术出院的前5个病种分别为:肿瘤相关治疗256例(19.18%)、其他椎间盘疾患141例(10.56%)、骨质疏松不伴有病理性骨折130例(9.74%)、脊椎关节强硬50例(3.75%)、其他和不明确部位的继发性恶性肿瘤38例(2.85%)。结论多数骨科未手术出院的患者,可以通过大力开展择日住院及日间手术,推进日间化疗,完善门诊及住院医保报销比例,加强术前评估、宣教等措施加以避免,提高科室运行效率,使更多有手术住院指征的患者得到及时的收治。
Objective To analyze the causes of unoperated discharge of orthopaedic inpatients,and put forward corresponding countermeasures and intervention measures,in order to reduce the rate of unoperated discharge and improve the operation efficiency of the department.Methods The patients who were discharged from orthopedics department from January to December 2020 were selected as the research object.The relevant data were extracted from the home page data of the hospital’s electronic medical record system,and the medical records were consulted to clarify the reasons for the patients no operation discharge,and the related causes were retrospectively analyzed.Results(1)In 2020,1335patients were discharged without surgery,accounting for 21.03%of all discharged patients.(2)The main reasons for leaving hospital without operation were:conservative treatment,complications,follow-up chemotherapy treatment or anti-osteoporosis treatment after orthopaedic tumor operation,insufficient preoperative preparation.(3)The first five diseases without surgery were tumor related treatment 256 cases(19.18%),other intervertebral disc diseases 141 cases(10.56%),osteoporosis without pathological fracture 130 cases(9.74%),rigid spine and joint 50 cases(3.75%),secondary malignancies of other and undefined sites 38 cases(2.85%).Conclusion Most patients who have not been discharged from orthopedics surgery can be avoided by vigorously carrying out selective hospitalization and daytime surgery,promoting daytime chemotherapy,improving the reimbursement ratio of outpatient and inpatient medical insurance,and strengthening preoperative evaluation and education,so as to improve the operation efficiency of the department,so that more patients with indications of manual hospitalization can be admitted in time.
作者
杨倩倩
叶世岳
郭顺萍
YANG Qianqian;YE Shiyue;GUO Shunping(Department of Medical Affairs,The First Affiliated Hospital of Fujian Medical University,Fuzhou Fujian 350005,China)
出处
《中国卫生标准管理》
2022年第17期95-99,共5页
China Health Standard Management
关键词
未手术出院
原因分析
择日住院
日间手术
手术指征
运行效率
discharged without operation
cause analysis
selective hospitalization
day surgery
indications of operation
operating efficiency
