某三甲医院超长住院日患者分布特征与影响因素分析

The Distribution Characteristics and Analysis of Influencing Factors of Over-long Hospitalization Days in a Three A and Tertiary Hospital

目的为缩短某院超长住院日,分析某三甲医院超长住院日患者分布特征与影响因素,为医院管理者决策提供参考。方法从某三甲医院HIS系统中检索并整理出院日期为2013年1月1日-2017年12月31日共4062条超长住院患者病案首页信息,对住院天数、性别、年龄、出院科室、疾病诊断、住院费用、离院方式及转归等指标进行统计分析。结果近5年超长住院日患者中男性比例高于女性患者,住院日31天~40天(57.31%),大于60岁以上的患者(57.19%)人数最多,出院科室排名前3位的分别为肿瘤科(17.78%)、骨科(12.79%)、普外科(11.85%)。疾病诊断排前3位疾病名称分别为恶性肿瘤(18.93%)、与保健机构接触(17.82%)、损伤中毒和外因(14.48%)。超长住院日患者的平均住院费用86 952.81元,主要以医嘱离院(93.21%)、好转(72.77%)为主。以上因素经过假设检验,均有统计学意义(P<0.05)。结论医院应当加强对超长住院日患者影响因素的监测与管理,针对重点科室、病种、人群加强监管,合理配置医疗资源,缩短平均住院日,为提升医院的质量和效率提供指导。

Objectives To analyze the distribution characteristics and influencing factors of patients with over-long hospitalization days in a hospital, so as to provide evidence for shortening the length of over-long hospitalization days for hospital administrator. Methods The information come from the front pages of medical records from January 1 st in 2013 to December 31 st 2017, was retrieved and collected from the HIS of a tertiary hospital. And make statistical analysis on the items such as age, sex, hospital department, disease diagnosis,hospitalization expenses, way of departure and prognosis and so on. Results The male proportion of the over-long hospitalization days was higher than that of the female patients in the last 5 years. The hospitalization day was 31 days ~40 days(57.31%), the number of patients above 60 years old(57.19%) was the most, the top 3 in the discharge department were the oncology(17.78%), orthopedics(12.79%) and general surgery(11.85%). The top three diseases were malignant tumors(18.93%), contact with health care institutions(17.82%), injury poisoning and external causes(14.48%). The average hospitalization expenses of patients with over-long hospitalization days were 86952.81 yuan, mainly from hospital orders(93.21%) and improvement(72.77%). Conclusions The hospital should strengthen the monitoring and management of patients with over-long hospitalization days of hospital, strengthen supervision on key departments and diseases, rationally configure medical resources, shorten the average hospital days, and provide guidance for improving the quality and efficiency of hospital management.