循环系统疾病患者住院时间超过30天影响因素分析

Discussion on the Influencing Factors of the Hospitalization Time of Patients with Circulatory System Diseases for More than 30 days

目的通过分析循环系统疾病患者住院时间超过30天的影响因素,探讨缩短该类疾病平均住院日的措施,为提高医疗质量水平、合理利用医疗资源提供依据。方法提取北京市某三级甲等医院2016年循环系统疾病出院患者的住院病案首页信息,将循环系统疾病患者定义为主诊断为I00-I99的出院患者,将住院天数≥30天定义为超长住院日,运用多因素logistic回归分析,探索循环系统疾病出院患者超长住院日的影响因素。结果 2016年循环系统疾病出院患者的平均住院日为10.88天,其中超长住院日患者218例,若剔除这些超长住院日患者,平均住院日可缩短1.76天。运用卡方检验对患者基本信息和就诊信息的15个变量进行单因素分析,确定将有统计学意义的10个变量纳入多因素logistic回归分析,最终分析得出年龄、婚姻、入院途径、住院次数、是否手术、是否有31天内再住院计划对循环系统疾病患者超长住院日的影响具有统计学意义(P<0.05)。结论对于循环系统疾病的住院患者应关注高龄患者、急诊入院患者、首次住院患者、有31天内再住院计划患者。在保证围手术期患者安全的同时,也应高度关注非手术患者。此外,应加强超长住院日患者管理,加强预警机制,针对重点科室和病种加强管理;大力发展医联体,积极开展转诊工作,合理利用医疗资源。

Objective To analyze the influencing factors of the hospitalization time of patients with circulatory system diseases for more than 30 days and to discuss the measures of shortening the average hospitalization days of these diseases, providing reference for medical institutions to improve social benefit and rational use of medical resources. Methods Medical record information of circulatory system diseases in 2016 from a hospital in Beijing were collected, and the patients with circulatory system diseases are defined as the discharged patients with primary diagnosis of I00-I99, the hospital stay more than 30 days is defined as the over-long hospitalization days. Through the Logistic regression analysis to determine the influencing factors of the discharged patients with circulatory system diseases and over-long hospitalization days. Results In 2016, the average hospitalization days of discharged patients with circulatory system diseases is 10.88 days, there is 218 cases of patients with over-long hospitalization days among them. The average length of hospital stay could be shortened by 1.76 days if the length of hospital stay was excluded. To analyze the 15 variables of patient＇s basic information and medical information by using Chi square test,ensure 10 variables with statistical significance were determined by multivariate Logistic regression analysis. Finally found that age, marriage, admission pathway, hospitalization frequency, whether to surgery and whether plan to re-hospitalization within 31 days is one of the influencing factors of over-long hospitalization days. Conclusion For patients with circulatory system, attention should be paid to older patients, emergency admissions, first hospitalizations, and 31 day re-hospitalization plans. At the same time to ensure the safety of perioperative patients,Close attention should be paid to non surgical patients. Moreover, it is necessary to strengthen the management of patients with over-long hospitalization days, strengthen the early warning mechanism, strengthen the management of key departments and diseases, vigorously develop the medical conjoined, actively carry out referral work, and make rational use of medical resources.