摘要
目的综合分析上海某三甲医院超长住院日患者分布特征,提出管理对策,为缩短平均住院日、提高医疗资源利用率提供参考依据。方法从医院电子病案系统中调取2016年-2019年出院患者住院病案首页相关信息,将住院时间≥30天定义为超长住院日。采用Excel2019、SPSS22.0软件对超长住院日患者年龄、出院科室、疾病种类等相关因素进行数据统计分析,确定影响因素并提出管理对策。结果超长住院日患者共5450例,占全部患者总数2.10%;其中住院日分布集中在30天~59天,60岁~74岁患者占比最高(为37.85%),各年龄段之间具有显著差异(P<0.001);出院人次排名前五位科室分别是血液内科、神经外科、普通外科、骨科和肿瘤内科。疾病分类排前三的为:肿瘤、影响健康状态和与保健机构接触的因素和循环系统疾病。结论重点关注住院天数在60天以内的中老年患者以及疾病分类前三位疾病患者,对重点人群和科室的超长住院日患者进行动态监管,建立超长住院日患者出院分流的长效机制,不断提升医疗质量和服务效率。
Objectives To analyze the distribution characteristics and put forward management countermeasures of over-long hospitalization days patients in a Three A and Tertiary Hospital,so as to provide reference for shortening the average length of stay and improving the utilization rate of medical resources.Methods The data of inpatients with length of stay over 30 days from January 1st,2016 to December 31st,2019 were obtained from the homepage of medical records in the hospital medical record system.After sorting out the data of age distribution,department distribution,disease type distribution and other related factors by Excel2019,SPSS22.0,the actual influencing factors were determined and the countermeasures were proposed.Results There were 5450 over-long hospitalization inpatients,the length of stay was concentrated in the range of 30-59 days(2.10%of all patients).Patients aged from 60 to 74 years account for the highest proportion of over-long hospitalization inpatients(37.85%),there were significant differences among different age groups(P<0.001).The top five discharged departments were hematology department,neurosurgery department,general surgery department,orthopedics department and oncology department.The top three categories of diseases were:tumor,factors affecting health status and contact with health care institutions,and circulatory system diseases.Conclusions The hospital should strength the supervision and management on patients over 30 days of hospitalization in key departments and diseases,optimize the medical management process,strengthen supervision of key groups and departments and improve the two-way referral of the medical consortium,which would provide guidance for the rational allocation of medical resources and increase the efficiency of hospital admission.
作者
杨柳
李福兴
徐惠
王飞
Yang Liu;Li Fuxing;Xu Hui;Wang Fei(Department of Medical Affairs,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China;不详)
出处
《中国病案》
2023年第4期22-24,共3页
Chinese Medical Record
基金
上海市医院协会基金项目(ZL2021006)
上海申康医院发展中心临床管理优化项目(SHDC12020618)。
关键词
三甲医院
超长住院日
分布特征
Three A and Tertiary Hospital
Over-long hospitalization days
Distribution characteristics
