眼部疾病31日内再入院指标评价及影响因素分析

An Analysis of the Influence Factors and Evalutiou of Readmission Indicator of Readmission in 31 Days Based on the Ophthalmology Diseases

目的探讨基于眼部疾病的31日内再入院指标的合理性,分析非计划性再入院原因。方法利用病案首页提取31日内再入院患者,随机抽取30%的样本作为研究对象,结合病历内容,给每份病历标明再入院原因及分类,采用描述性统计与卡方检验分析。结果随机抽样样本量1 297人次,计划性再入院1 140人次(占87.90%),主要原因为计划性手术(占83.27%);非计划性再入院157人次(占12.10%),主要原因为首次住院中术前出现手术禁忌症(占7.25%)。白内障患者非计划性再入院构成比最低(占2.44%);斜视患者构成比最高(占96%)。患者来源与住院形式是再入院结构的影响因素(P<0.05)。结论建议结合病案首页与病历内容判断再入院是否为非计划性。患者来源、年龄、病种、住院形式是再入院构成的重要影响因素。减少非计划性再入院需要我们控制好患者术前手术禁忌症、做好患者术前沟通、术前健康教育、完善术前检查、病房感染管理以及出院指导工作。

Objective To explore the rationality of the indicator of readmission in 31 days,and analyze the reasons of unscheduled readmission. Methods 30% samples were randomly selected from the readmission in 31 days computed by hospital medical record first page,combined with medical records content,and the reasons and classification of readmission were labeled,and were analyzed by using descriptive statistics and chi square test. Results The random sample cases is 1 297,of which planned readmission cases is 1 140（87.90%）,with the main reason for planned operation（83.27%）; unscheduled readmission cases is 157（12.10%）, for operation contraindications（7.25%） before operation in index hospitalization. The proportion of unscheduled readmission was the lowest（2.44%） in Cataract patients and was the highest（96%） in Strabismus patients. The source of patients and the hospitalization pattern were the influencing factors on the structure of readmission（P0.05）. Conclusion It is suggested that the combination of medical record first page and medical records content to determine whether the readmission is unscheduled. The source, age, disease, and hospitalization of patents were the important influencing factors of readmission. Controlling the operation contraindication before operation in the index hospitalization,having a good communication with patients before operation, preoperative health education, perfect preoperative examination, ward infection management and discharge guidance work are needed to reduce unscheduled readmission.