某三甲医院影响患者出院结账非住院处因素的现状调查

Investigation on Current Situation of Non-inpatient Service Factors Affecting Discharge Settlement of Patients in a Hospital of Class A Grade Three

目的探讨影响患者出院结账的非住院处因素,为制定相应改善措施提供理论依据。方法对3 586名出院患者出院结账情况进行调查统计,采用χ2检验分析医院内部各部门、患者住院天数、护理级别及出院结账时间对患者出院结账影响的差异。结果 1 187名出院患者在出院结账时由于非住院处因素发生延迟,占所有出院患者的33. 10%;不同住院天数出院患者结账受延迟百分率存在差异(P <0. 01),住院天数越长出院患者结账受延迟比例越大;不同护理等级间患者出院结账受延迟百分率存在差异(P <0. 01),不同护理等级患者出院结账延迟百分率不同,病情越重受延迟比例越高;不同结账时间患者出院结账受延迟百分率存在差异(P <0. 001),周一至周五患者出院结账受延迟比例较周六至周日高;在所有的影响因素中,医生方面影响因素在所有影响因素中所占比例最高,占比49. 88%。结论患者出院结账过程中存在较多的非住院处影响因素,患者出院结账延迟受诸多因素影响,医院应采取针对性措施改善患者出院结账延迟现象。

Objective: To explore the factors that affect patients’ discharge settlement and provide theoretical basis for the development of the corresponding improvement measures. Methods:A total of 3,586 discharged patients were investigated and statistically analyzed.And C2 test was used to analyze the influence of different departments in the hospital,the number of days in hospital,the nursing level and the discharge checkout time on the patients’ discharge checkout. Results:1 187 discharged patients were delayed due to non-inpatient factors at discharge checkout,accounting for 33.10% of all discharged patients.There was a difference in the percentage of delayed checkout of the discharged patients with different days of hospitalization (P<0.01),and the longer the days of hospitalization was,the greater the proportion of delayed checkout of the discharged patients would be.There was a difference in the delayed percentage of discharge settlement among patients with different nursing grades (P<0.01).The more severe the condition was,the higher the delayed percentage was.There was a difference in the percentage of delayed checkout in patients with different checkout times (P<0.001).The percentage of delayed checkout in patients with different checkout times from Monday to Friday was higher than that from Saturday to Sunday.Among all the influencing factors,the factors related to doctors accounted for the highest proportion,accounting for 49.88%. Conclusion:There are many influencing factors in the discharge checkout process of patients,and the delay of discharge checkout.The hospitals should take targeted measures to improve the delay of discharge checkout.