综合医院康复科住院患者分析

Analysis of the in-patients in the rehabilitation department of a general hospital

目的探讨综合医院康复科住院患者的疾病种类、患者来源、住院日和住院费用的特点。方法利用“广东省病案查询统计系统”回顾查询2004至2005年在康复科出院的全部病例1246例,统计分析患者的年龄、疾病诊断数、患者来源、平均住院日和住院费用。结果2005年出院患者平均年龄(61．2±13．7)岁；第一诊断脑梗死占40．4%,脑出血12．6%,颈椎病5．7%,脑外伤5．1%,骨折3．7%；患者平均患病病种(5．52±1．54)个；患者首次入院科室以康复科最多,占47．7%,转科患者占52．3%,其中神经内科26．4%,神经外科7．9%,骨科4．1%；人均住院时间为39．1 d,康复科入院患者23．7 d,神经内科入院患者44．4 d,骨科患者60．2 d,神经外科患者62．4 d；脑梗死患者人均住院时间为34．2 d,骨折63．5 d,颈椎病21．3 d,颅脑外伤64．2 d；人均住院总费用36 167．7元,其中药品费最高,占47．6%,其次是治疗费。颈椎病的费用最低,颅脑外伤最高。结论康复科住院患者病种多,人均患病数多,转科患者多,住院时间长,住院费用高,药品费比例过高。应该在患者转科前开展康复治疗,减少用药,才能缩短住院日,降低费用,减轻患者的负担。

Objective To investigate the disease categories （DCs） , admitting departments（ADs） , length of stay （LS） , and hospital costs （HCs） of the in-patients in the rehabilitation department of a general hospital. Methods A total of 1 246 in-patients admitted to the authors＇ rehabilitation department over the period from 2004 to 2005 were analyzed retrospectively with regard to their age, DCs, ADs, LS and HCs by means of the Hospital Case Enquiry and Statistical System of Guangdong Province. Results The average age of the in-patients in 2005 was 61.2 ± 13.7 years, and their average number of DCs was 5.52 ± 1.54. Common first diagnoses included cerebral infarct （40.4%） , cerebral hemorrhage （ 12.6% ） , cervical spondylosis （5.7%） , traumatic brain injury （5. 1% ） , and fracture （3.7%）. Rehabilitation （52.3% ,） , neurology （26.4%） , neurosurgery （7.9%） and orthopedics （4.1%） were the most common initial admitting departments. The average LS was 39. 1 d, and the LS of patients with rehabilitation, neurology, orthopedics and neurosurgery as their initial admitting department was 23.7 d ,44.4 d, 60.2 d and 62.4 d, respectively. The average LS of those with their first diagnosis as cerebral infarct, cervical spondylosis, traumatic brain injury and fracture was 34.2 d, 21.3 d, 64.2 d and 63.5 d, respectively. The average HCs were 36 168 yuan RMB, with the cost of medicine the highest （47.6%） , followed by costs for various therapies. The costs for cervical spodylosis were the lowest, while those for traumatic brain injury were the highest. Conclusion The rehabilitation in-patients usually had multiple DCs, needed lengthy stays and incurred high hospital and medicine costs. It is suggested that early rehabilitation interventions should be implemented before the patients are transferred to the rehabilitation ward so as to reduce HCs and LS.