地市级医院日间手术治疗模式的实践与效果分析

Practice and Effect Analysis of Daytime Surgical Treatment Mode in Prefectural and Municipal Hospitals

目的观察地市级医院日间手术治疗模式的应用效果,并总结实践经验。方法 2015年5月—2018年5月我院开始推行日间手术治疗模式,选择该模式建立后接受日间手术治疗31 105例患者作为建模后组,另选择模式建设前(2013年5月—2015年4月)在本院行手术治疗的19 841例患者作为建模前组。观察并记录两组患者平均手术时间、手术等候时间、平均住院时间,并对比两组患者平均总费用、平均医保支付、平均个人自付、自付比例。结果建模后组平均手术时间(3.61±1.02)h、手术等候时间(1.62±0.33)d、平均住院时间(1.04±0.26)d,均明显短于建模前组(5.67±1.64)h、(3.13±0.64)d、(4.30±1.02)d,组间差异有统计学意义(P <0.05)。建模前组患者平均总费用(6 348.56±845.21)元、平均医保支付(4 075.63±365.4)元、平均个人自付(2 273.06±562.32)元、自付比例(55.23%),高于建模后组(2 689.07±857.36)元、(751.94±403.10)元、(1 937.23±423.11)元、28.92%,差异均具有统计学意义(P <0.05)。结论在地市级医院中建设并推行日间手术治疗模式,有助于减缩患者术后住院时间,降低就医成本,并提升了医疗资源的有效利用率。

Objective To observe the effect of daytime surgical treatment mode in prefectural and municipal hospitals and summarize the experience.Methods From May 2015 to May 2018,our hospital began to implement the daytime surgical treatment model.3 1105 patients who received daytime surgical treatment after the establishment of the model were selected as the post-model group,and 19 841 patients who received surgical treatment before the model construction(from May 2013 to April 2015)were selected as the pre-model group.The average operation time,waiting time and hospitalization time of the two groups were observed and recorded.The average total cost,average medical insurance payment,average individual self-payment and self-payment ratio of the two groups were compared,and the economic burden of the patients was evaluated.Results The average operation time,waiting time and hospitalization time of the model group were(3.61±1.02)h,(1.62±0.33)d and(1.04±0.26)d respectively,were significantly shorter than those in the pre-modeling group(5.67±1.64)h,(3.13±0.64)d,(4.30±1.02)d,there was significant difference between the two groups(P<0.05).The average total cost of the pre-model group was(6 348.56±845.21)yuan,the average medical insurance payment was(4 075.63±365.4)yuan,the average personal self-payment(2 273.06±562.32)yuan,the proportion of self-payment(55.23%),were higher than that of the post-modeling group(2 689.07±857.36)yuan,(751.94±403.10)yuan,(1 937.23±423.11)yuan,28.92%,the difference was statistically significant(P<0.05).Conclusion The construction and implementation of daytime surgical treatment mode in municipal hospitals can help to reduce the postoperative hospitalization time of patients,reduce the cost of medical treatment and improve the effective utilization rate of medical resources.