摘要
目的 分析某骨伤科手术患者住院超30天影响因素,探讨缩短平均住院日的措施。方法 采用回顾性研究方法,应用Microsoft Office Excel 2016和SPSS 26.0,对某院出院日期在2018年1月1日-2022年12月31日期间的745例住院日超30天骨伤科手术患者病例信息进行统计学描述,在文献研究和问卷调查基础上,通过卡方检验和Logistic回归分析研究住院日超30天骨科手术患者影响因素。结果 纳入研究对象25 041例,其中住院超30日患者745例(2.98%),男女比例1.48:1,41~60岁最多(39.2%),其次是61~80岁(35.4%)。住院日超30天骨伤科手术患者比例逐年下降,具有统计学意义,Z=61.285,P<0.001。二分类Logistic逐步回归分析结果显示,男性、年龄、县内患者、急诊入院、转科、术前等待日0天和≥3、出院诊断≥3个、手术治疗费>3000元、胫骨骨折、股骨骨折、跟骨骨折、腰椎间盘突出是住院日超30天的危险因素。结论 医院应加强手术管理,缩短术前等待日,强化医患沟通,完善转诊制度和流程,优化病种诊疗方案,加强双向转诊,建立住院日超30日患者预警报告制度,缩短平均住院日。
Objectives To analyze the influencing factors of more than 30 days in hospital for a patient with orthopedic surgery,and explore the measures to shorten the average days in hospital.Methods A retrospective study was conducted using Excel 16.0 and SPSS 26.0,a statistical description of case information of 745 orthopedic patients who underwent orthopaedic surgery with a discharge date of more than 30 days from January 1st,2018,to December 31st,2022 was performed,was made on the basis of a literature review and a questionnaire survey,chi-square test and Logistic regression analysis were used to study the influencing factors of orthopaedic surgery patients with over 30 days hospitalization.Results From 2018 to 2022,there were 25041 orthopedic patients,of whom 745(2.98%)were hospitalized for more than 30 days.The ratio of male to female was 1.48:1,and the age of 41~60 was the most(39.2%),the second was 61~80 years old(35.4%).With the increase of years,the proportion of patients with over 30 days hospitalization showed a decreasing trend(Z=61.285,P<0.001).The results of binary Logistic stepwise regression analysis showed that male,age,patients in county,emergency admission,transfer,waiting days 0 days and over3 days before operation,discharge diagnosis more than 3 ones,operation treatment fee more than 3000 yuan,tibia fracture,femoral fracture,calcaneal fracture,lumbar disc protrusion were the risk factors of over 30 days in hospital.Conclusions The hospital should strengthen the management of operation,shorten the waiting time before operation,strengthen the communication between doctors and patients,perfect the system and procedure of referral,optimize the diagnosis and treatment plan of diseases,and do the two-way referral well,the establishment of more than 30 days inpatient early warning and reporting system,effectively shorten the average length of stay.
作者
张盼盼
高波
陈磊
班文明
Zhang Panpan;Gao Bo;Chen Lei;Ban Wenming(Taihe Hospital Affiliated Anhui College of Traditional Chinese Medicine,Taihe 236607,Anhui Province,China;不详)
出处
《中国病案》
2024年第6期80-84,共5页
Chinese Medical Record
