住院患者再住院系列指标在质量管理监测中的应用

Use of the Re- Hospitalization Indexes for Inpatients in Quality Management Monitoring

目的 构建住院患者再住院监测指标,探索再住院影响因素.方法 通过HIS系统采集2013年1月～10月出院后再次入院患者的诊断、科室、住院天数、费用等信息,按疾病诊断ICD-10分类统计病种再住院率.结果 再住院主要为诊疗需要,如肿瘤化疗等,占82.13％.因可疑医疗质量问题和以缩短平均住院日为目的的再住院率分别为2.10％和1.37％.结论 再住院率指标能够在一定程度上反映医疗和管理方面的问题,特别是对主要病种、主要术种的监测,不同医院间具有可比性.但其影响因素复杂,仅根据表面结果尚不能定论,再入院筛选规则需根据医院实际情况逐步探索.

Objective To construct the monitoring indexes for re - hospitalization of inpatients, and to explore influencing factors on re - hospitalization. Method The data of inpatients with re - hospitalization during January to October 2013 on diagnosis, department, length of stay, expenses, etc. , were collected through HIS system, and the re -hospitalization rate was analyzed on the basis of ICD - 10 categories. Result Re - hospitalization was mainly for medical treatment purpose, such as chemotherapy for cancer, accounting for 82.13%. The re - hospitalization rates due to suspicious medical quality problem and reduction of the average length of stay were 2.10% and 1.37% , respectively. Conclusion The re - hospitalization indexes can reflect the quality problems on medical treatment and management, especially for the monitoring of major diseases and therapies, and can be compared across different hospitals. However, the influencing factors are complicated, and solid conclusion cannot be obtained merely based on the superficial results. The screening rule needs to be further explored according to management pattern of hospitals.