新疆某三甲医院骨科患者术前平均住院日影响因素主成分分析

Factors influencing the average length of hospital stay:PCA study on patients of orthopedics in a Grade 3 and Class A Hospital of Xinjiang Medical University

目的采用主成分分析法筛选新疆医科大学某三甲医院骨科患者术前平均住院日的主要影响因素,为缩短患者术前平均住院日提供更有针对性的理论依据。方法采用专家咨询法和文献检索法筛选骨科患者术前平均住院日影响因素,确定调查问卷,对2014年1-6月份骨科78例术后患者及22名医护人员进行影响因素影响程度问卷的调查,运用主成分分析法提取影响患者平均住院日的主要因素。结果主成分分析结果根据山麓图和主成分分析筛选要求,在19个影响因素中提取出4个主要成分,其中患者经济条件和依从性是影响术前住院日的第一主成分,医院的相关制度是影响术前住院日的第二主成分,医患沟通是影响术前住院日的第三主成分,医院物理环境是影响术前住院日的第四主成分。结论影响骨科患者术前平均住院日的主要因素为患者因素、医疗相关制度因素、医患沟通因素和医院物理环境因素。建议采取增强医患沟通、提高患者依从性、倡导人性化就医、改善医院物理环境、加强临床路径管理、改善医院制度问题等针对性措施,更好更快改善现有状况,提高医院绩效管理。

Objective A screening of main the influence factors of patients in the department of orthopedics, Affiliated Hospital of Xinjiang Medical University of some common diseases preoperative average length of stay, and provide a targeted theoretical basis for the further shortening the average hospitalization days of patients before operation. Methods Using expert consulting method and literature search to determine the questionnaire. A questionnaire survey was conducted in 100 postoperative patients of orthopedic common diseases on June 1-6, 2014. Screening influence factors of average hospitalization days. Principal component analysis （PCA） was applied to extract the main influence factors of average hospitalization days. Results Four major components were screened out in the total of nineteen according to piedmont figure and PCA . Economic conditions and compliance of patients is the first principal component, the system of hospital is the second principal component, doctor-patient communication is the third princi pal component, the hospital physical environment is the fourth principal component affecting the preoperative such confinement. Conclusion The average hospitalization days were influenced by the patient factors, medical system, doctor-patient communication and hospital physical environment factors , Some measures are needed to include as follows： Enhance the doctor-patient communication, improve patient compliance, advocate humane treatment, improve the hospital physical environment, strengthen the man agement of clinical pathway and so on.