床位分类管理对医院绩效改善的研究:以上海市某医疗集团骨科为例

Study on the improvement of hospital performance by bed classification management-A case study of orthopedics in a medical group in Shanghai

目的:分析患者由治疗床位转诊到康复床位的住院天数、住院费用等信息,为转诊管理和床位分类管理研究提供依据。方法:从一所三级医院和一所二级医院病案管理系统导出骨科患者数据,利用Excel 2016和Access 2016进行数据整理匹配,利用SPSS 18.0进行数据分析。结果:8.14%主诊断的患者占总数的60.08%;治疗床位和康复床位住院天数的中位数分别为6天、12天;治疗床位和康复床位患者住院费用和日均住院费用的中位数分别为39295元、6530元和5411元、574元;82.76%股骨颈骨折住院费用发生在治疗床位。结论:床位分类管理可节省三级医院床日、为更多患者提供入住机会,可推动分级诊疗实现、促进各级医院回归功能定位,但仍需探索配套政策和管理研究。

Objectives： To analyze data of patients referred from therapeutic beds to rehabilitation beds including length of stay and hospitalization cost, and to provide evidence for practice and research of bed classification management. Methods： Data of orthopedics patients were derived from the medical record system of a tertiary level general hospital and a secondary level general hospital. Microsoft Excel 2016 and Access 2016 were used for data sorting, and SPSS 18.0 was used for data analysis. Results： Patients of 8.14% primary diagnosis accounted for 60.08%. The median of length of stay for therapeutic and rehabilitation beds were 6 days and 12 days. Median of hospitalization cost and cost per day for therapeutic and rehabilitation beds were 39,295 Yuan, 6,530 Yuan and 5,411 Yuan, 574 Yuan. For femoral neck fracture patients, 82.76% cost were spent in therapeutic beds. Conclusions： Through bed classification management and referral, tertiary level hospitals can save length of stay for more patients. Hospitals at different levels can adjust their role, which may promote the realization of hierarchical hospital visit. However, the management mode and support policy needs to be further researched.