某三级综合医院超长住院日患者的影响因素分析及应对策略

Analysis of the Influencing Factors of the Patients with Long Hospital Stay in a Comprehensive Hospital of Grade Three

目的为合理控制住院时间,使有限的医疗资源服务更多患者,本研究分析某三级综合医院超长住院日患者分布特征及影响因素,探索应对策略。方法统计分析医院2015—2018年住院时间大于60 d的超长住院日患者的分布特征。结果超长住院日患者中男性占比高于女性;超长住院日患者的产生与年龄因素相关,越高龄的年龄组占比越多;费用类别构成中,医保及公费医疗患者占绝大多数;病种的构成中,循环系统疾病与呼吸系统疾病患者占超长住院日患者的半数以上。结论加强重点科室及疾病的患者管理、把握医疗质量关键环节、深入沟通及告知、防控医疗风险减少医患纠纷、加强医联体建设是控制住院时间延长的有效途径。

Objective:To reasonably control the length of hospital stay and provide more patients with limited medical resources,this study analyzed the distribution characteristics and the influencing factors of patients with long hospital stay in a comprehensive hospital of grade three,and explored the coping strategies.Method:Statistical analysis was made on the distribution characteristics of patients with very long stay in hospital from 2015 to 2018,whose length of stay was more than 60 days.Result:The proportion of male patients with long hospital stay was higher than that of female patients.The occurrence of patients with very long hospital stay was related to age.The older the age group was,the higher the proportion was.In the cost category,the patients with medical insurance and public medical treatment accounted for the vast majority.As for the composition of diseases,circulatory and respiratory diseases accounted for more than half of the patients staying in hospital for a long time.Conclusion:Strengthening patient management of key departments and diseases,grasping key links of medical quality,in-depth communication and notification,preventing and controlling medical risks,reducing doctor-patient disputes,and strengthening medical alliance construction are effective ways to control the extension of hospital stay.