山西省41家医院胃癌住院日影响因素分析

Analysis of Influential Factors on Length of Stay in 41 Hospital for Patients of Gastric Cancer in Shanxi Province

目的了解胃癌患者住院日的影响因素,为医院及卫生主管部门管理决策提供参考依据。方法收集山西省41所三级医院2014年一季度胃癌患者出院首页数据,利用多重线性回归统计学方法,回顾性分析胃癌患者住院日与患者性别、年龄、地区、付费方式、伴随诊断数量、手术、医院类型7因素的相关性。结果不同性别组、年龄组、付费方式组住院日比较无统计学意义(t=0.210,P=0.834;F=1.342,P=0.252;2χ=5.945,P=0.312),是否手术、医院类型、伴随诊断数量、不同地区(Mann-Whitney检验)组住院日比较有统计学意义(2χ=52.489,P<0.001;2χ=32.924,P<0.001;t=-21.026,P<0.001;Z=-8.149,P<0.001)。结论医院加强手术患者的管理、严格把握手术适应症、优化手术患者诊疗流程设计与管理、开展与基层医院双向转诊服务等对降低患者住院日水平有帮助;同时,卫生主管部门应引导患者理性选择就医地点,不盲目追求名医名院,避免出现少数医院患者过度集中现象,这不仅可有效缓解患者看病难看病贵,而且对缩短患者住院日也有实际意义。

Objective To investigate the influential factors on length of stay in hospital for patients of gastric cancer, and provide references for the hospital and health authorities to make managerial decisions. Methods The data of gastric cancer patient＆#39;s first-page information from 41 tertiary hospitals in Shanxi province was collected in the first quarter of 2014.By using multiple linear regression statistical method, the correlation between length of stay for patients of gastric cancer with other 7 factors like gender, age, district, payment method,surgery,amount of diagnoses,hospital type was analyzed retrospectively. Results There was no significantly statistical difference for length of stay in different gender groups,different age groups and different payment method groups（t=0.210,P=0.834;F=1.342,P=0.252;χ2=5.945,P=0.312）.But,in other groups such as place,amount of diagnoses, surgery situation and type of hospital,the results were significantly different for length of stay （χ2=52.489,P〈0.001;χ2=32.924,P〈0.001;t=-21.026,P〈0.001;Z=-8.149,P〈0.001）.Conclusion Health authorities and hospitals should strengthen the standardized management of operation treatment and the management of diagnosis and therapy process, meanwhile, the department should guide the patients to choose the proper hospital for medical treatment reasonably.The method mentioned above could reduce soaring medical expenses and declining availability of medical services effectively, and reduce the length of staying in hospital.