医院床位周转率对药占比的影响

Influence of Turnover Rate of Hospital Beds on Drug Proportion

目的：探讨住院患者费用在整个住院期间的分布走势，找出其占最大权重的住院时间段，为医院控制患者住院天数提高床位周转率、保障医疗安全提供有效依据。方法：分析我院2013年9月～2013年11月出院的2444例住院时间在1～20d的病例，对其进行分组（内科组、外科手术组与外科非手术组）统计住院费用、药品费用等指标，并进行比较。结果：内科与外科手术组及外科非手术组日费用总体比较，差异有统计学意义（P〈0．01），而外科手术组与外科非手术组日费用总体比较，差异无统计学意义（P〉0．05）；手术组日费用呈直线下降趋势，内科及外科非手术组呈对数曲线下降趋势；各组内前后10d费用比较，差异有统计学意义（P〈0．05），药占比在内、外科组均显示随着住院天数的延长而逐渐上升。结论：缩短住院天数是降低药占比的有效方法。外科最为明显，药品比例随住院天数延长而上升。

Objective： To research the expense distribution of discharged patients during hospitalization to find out the period with the greatest weight, and provide reliable evidence for the increase of turnover rate by controlling hospitalization of patients and medical security. Methods： Totally 2 444 discharged patients of our hospital from September to November in 2013 with stay day of 1 to 20 d were analyzed, and then divided into the internal medicine group and surgical groups including surgical operation group and surgical without operation group. The hospitalization expenses and drag expense in all the groups were counted and compared. Results： The daily expense in the internal medicine group showed significant difference when compared with that in the surgical operation group and surgical without operation group （P 〈 0.01 ）, meanwhile, that in the two surgical groups had no significant difference （ P 〉 0.05 ）. The daily expense in the surgical operation group was with linear decrease, and that in the other groups was with logarithmic decline. The 10-day expense in each group had significant difference （P 〈 0.05 ） compared by median test. The expense proportion of drugs in all groups was generally increased along with the hospitalization days. Conclusion： The effective method for the decrease of drug proportion is shortening hospitalization days, especially in surgical departmens, the drug proportion is increased along with the length of stay.