康复医学科124例患者住院时间超30d的原因分析及对策研究

Analysis of Causes and Countermeasures of 124 Cases of Patients in Rehabilitation Medicine Department for More Than 30 Days

目的：对笔者所在医院康复医学科住院时间超30 d的124例患者的原因进行分析,并提出相应对策。方法：选取2014年10月-2015年9月于笔者所在医院康复科住院治疗的住院时间超30 d的患者124例为研究对象。利用医院病案管理系统采集患者的临床资料,包括性别、年龄、住院天数、出院科室、出院诊断、出院情况等,通过科室的《住院超30 d患者上报表》及电子病案分析患者住院时间超过30 d的原因,并对原因进行分析,提出相应对策。结果：在住院时间超过30 d的患者中,60岁以上患者69例,占55.6%;40～59岁37例,占29.8%;20～39岁13例,占10.5%;19岁以下患者仅为4.0%。随年龄增加患者构成比增加。神经内科患者67例,占54.0%;其次为ICU 25例,占20.2%;神经外科17例,占13.7%;骨科10例,占8.1%;小儿科5例,占4.0%。第一诊断为脑梗死的患者比例最高,共71例,占57.3%;其次为脑出血23例,占18.5%;骨折患者14例,占11.3%;颈椎病或腰椎间盘突出症10例,占8.1%;颅脑外伤者6例,占4.8%。结论：康复医学科中住院超过30 d的患者具有年龄大、以神经内科疾病为主等特点,其原因与患者自身及疾病特点均密切相关,为了最大程度合理配置有限的医疗资源,应将加强社区医疗服务中的康复服务作为我国今后的社区建设的重要内容之一。同时,对患者家属进行宣传教育,使其在生活与心理上对患者进行照顾与支持,使患者早日回归家庭,为其回归社会打下坚实的基础。

Objective：To analyze the causes of 124 patients in the rehabilitation medicine department of our hospital for more than 30 days,and to propose the corresponding countermeasures.Method：One hundred and twenty four patients in the rehabilitation medicine department of our hospital for more than 30 days from October 2014 to September 2015 were selected as the research objects.The clinical data of patients were collected by hospital medical record management system,including sex,age,hospital stay,hospital discharge department,discharge diagnosis,hospital discharge situation and so on.The reasons of hospitalization time exceeding 30 days were analyzed through ＂report of patients who stayed in hospital for more than 30 days＂and electronic medical record in order to put forward the corresponding countermeasures.Result：Among the patients who stayed in hospital for more than 30 days,69 patients were aged over 60 years,which accounted for 55.6%,37 cases were 40-59 years old,accounting for 29.8%,13 cases were 20-39 years old,accounting for 10.5%,patients under 19 years old only accounted for 4.0%.The constituent ratio increased according with the increasing of age.Nerve internal medicine patients were 67 cases,which accounted for 54%,25 cases were from ICU,which accounted for 20.2%,17 cases were from neurosurgery,which accounted for 13.7%,10 cases were from orthopedics,which accounted for 8.1%,5 cases were from pediatric,which accounted for 4.0%.The proportion of patients with cerebral infarction was the highest,71 cases,accounting for 57.3%,The second was cerebral hemorrhage,accounting for 18.5%,14 cases were fracture,accounting for 11.3%,10 cases were with cervical vertebra disease or lumbar disc herniation,accounting for 8.1%,6 cases were traumatic brain injury,accounting for 4.8%.Conclusion：The patients in rehabilitation medicine department for more than 30 days have the characteristics of older and mainly neurological disease.The reason is closely related with the characteristics of the patients themselves and the disease.In order to maximize the allocation of scarce medical resources rationally,strengthen community health service should be as one of the important content of community construction in the future in our country.At the same time,the family members of patients shall be given publicity and education,so as to make them give care and support to patients from life and mentally,which can make patients return home as soon as possible and to lay a solid foundation for their return to society.