基于数据中心的预住院模式效果评价

Effect Assessment of Pre-registration Hospitalization Based on Clinical Data Repository

目的评价预住院模式的效果。方法从医院数据中心抽取患者资料,选择医院骨科2019年3月—2019年12月试行预住院管理期间收治的1213名患者,并以骨科2018年3月—2018年12月未实行预住院模式期间收治的3981名非急诊入院患者做为对照组,比较两组患者人口学特征、既往史情况、术前评估情况和等待入院天数等。结果预住院可筛查出67%以上的有手术风险患者,患慢性疾病、评估异常患者等待入院天数更长(P<0.05)。预住院患者等待入院天数[11.36(5.45,21.62)vs.12.23(5.74,27.64),Z=-4.355,P<0.001]、等待手术天数[1.00(1.00,2.00)vs.2.00(1.00,3.00),Z=-11.698,P<0.001]和住院天数[5.00(4.00,7.00)vs.6.00(4.00,8.00),Z=-7.647,P<0.001]更短,患者床位费、护理费等医疗费用也均有下降(P<0.001)。结论预住院模式依托信息系统,实现患者就医流程追踪、患者管理和术前评估,可缩短等候住院天数和术前住院天数,控制手术风险。

Objective To evaluate effect of Pre-registration Hospitalization.Methods Data was collected from Clinical Data Repository,which contained 1213 patients who received Pre-registration Hospitalization Management from March 2019 to December 2019,and 3981 patients who were non-emergency and didn’t received Pre-registration Hospitalization Management from March 2018 to December 2018 as control group.Demographic characteristics,past medical history,preoperative evaluation,waiting time before hospitalization were compared.Results Preoperative evaluation could screen 67%patients who had surgery risk,and patients who had chronic diseases,abnormal test result,or abnormal preoperative evaluation result waited longer before hospitalization(P<0.05).Compared with control group,pre-registration hospitalization could reduce waiting time before hospitalization[11.36(5.45,21.62)vs.12.23(5.74,27.64),Z=-4.355,P<0.001],pre-operative waiting time[1.00(1.00,2.00)vs.2.00(1.00,3.00),Z=-11.698,P<0.001],length of stay[5.00(4.00,7.00)vs.6.00(4.00,8.00),Z=-7.647,P<0.001]and fees like bed fees,nursing cost,etc(P<0.001).Conclusion Pre-registration Hospitalization relayed on information system,accomplished medical process tracking,patient management and preoperative evaluation,which reduced waiting time before hospitalization and length of stay before operation,as well as control operation risk.