摘要
目的了解某院非医嘱离院患者的基本特征与相关因素。方法调取2019年1月1日-2023年6月30日出院患者住院病案首页信息,对患者非医嘱离院发生率,基本人口学和临床特征,及相关因素进行分析。结果298519例出院患者中,非医嘱离院10959例(3.67%)。非医嘱离院率前三位的科室为重症医学科、急诊科和感染性疾病科,前三位主要疾病分类于损伤中毒、呼吸系统疾病和妊娠、分娩产褥期。男性、贫困救助和全自费、无手术操作、入院病情临床未确定、急诊入院患者非医嘱离院风险高。非医嘱离院患者非计划再入院比例高,再入院时间间隔更短。结论非医嘱离院是多种因素综合作用的结果,医院应重点关注重症、急诊等科室,加强对特定病种患者和家属的有效沟通,推动医院高质量发展,降低非医嘱离院发生。
Objectives To understand the basic characteristics and related factors of patients discharge against medical advice.Methods To retrieve the front page information of inpatient medical records of patients discharged from January 1st,2019 to June 30th,2023,and analyze the prevalence,distribution characteristics and predictors of patients discharge against medical advice(DAMA)in the hospital from January 1st,2019 to June 31th,2023.Results Among 298519 discharged patients,10959 patients were discharged AMA,accounting for 3.67%.The top three departments of DAMA proportion were ICU,emergency department and department of Infectious Diseases,while the top three sequences of diseases were injury,poisoning and certain other consequences of external causes,diseases of the respiratory system and pregnancy,childbirth and the puerperium.Male,full self-expense and poverty relief groups,no surgical operation,uncertain condition of admission and transferred from emergency department were the risk factors of DAMA.DAMA patients were more likely to be readmitted shortly after initial discharge.Conclusions The occurrence of DAMA was a distressing phenomenon of multiple factors.Hospital should focus on departments such as ICU and emergency,strengthen effective communication with specific disease patients and their families,and promote the high-quality development of hospitals in order to reduce the occurrence of DAMA.
作者
李慧
吴婷婷
周艳平
黄晓芳
王珍
Li Hui;Wu Tingting;Zhou Yanping;Huang Xiaofang;Wang Zhen(The People's Hospital of Dongying,Dongying 257091,Shandong Province,China;不详)
出处
《中国病案》
2024年第10期11-14,共4页
Chinese Medical Record
关键词
非医嘱离院
现状分析
相关因素
Discharge against medical advice(DAMA)
Status analysis
Influencing factors
