981例住院超30天患者分布及影响因素分析

Analysis on the Distribution and Influencing Factors of 981 Inpatients with over 30-day Hospitalization

目的分析患者住院时间超30天的影响因素,为控制超长住院日提供参考依据。方法通过医院病案首页系统提取2020年1月1日-2020年12月31日期间住院天数超过30天的981例出院患者作为研究对象,采用住院时间超过30天患者信息上报表收集患者住院超30天的原因,应用χ^(2)检验和多因素Logistic回归分析住院时间超过30天的影响因素。结果住院超30天患者中男性359人(36.6%),女性622人(63.4%);平均年龄34.23±18.06岁,平均住院日42.97±0.46天;长期康复治疗需要、病情疑难和危重、等待第三方付费是各科室住院超30天患者的主要原因。入院途径、入院情况、转科情况、抢救次数、手术操作情况、医疗付款方式是患者住院超过30天的影响因素。结论医院应加强对住院时间超过30天患者的管理,重视高危因素人群管理,降低患者无效住院天数;落实医改政策,引导患者及时转院,降低住院费用;提高疑难危重病例的诊疗水平,规范诊疗行为,缩短医院平均住院日。

Objectives This study aims to analyze the influencing factors of inpatients hospitalized over 30 days in order to provide references for effective management of excessively prolonged hospitalization.Methods 981 inpatients with over 30-day hospitalization from January 1 to December 31,2020 were selected from the hospital medical record front page system as investigation subjects.The causing factors of over 30-day hospitalization were collected from the information report and the influencing factors were determined by Chi-square test and multivariate logistic regression analysis.Results Among the inpatients hospitalized over 30 days,359 were male(36.6%)and 622 were female(63.4%).The average age was 34.23±18.06.The average hospital staying was 42.97±0.46.The main reasons for over 30-day hospitalization were the requirement for long-term rehabilitation treatment,difficulties and complication of diseases,waiting for a third-party payment.The influencing factors of over 30-day hospitalization were admission path,admission condition,inter-department transfer,numbers of rescue,conditions of operation,the mode of medical insurance payment.Conclusions Hospitals should strengthen the management of the patients hospitalized for over 30 days,pay attention to the management of high-risk factors to reduce the invalid days,and implement the policy of medical reform,guide patients to transfer in time to reduce the cost of hospitalization,improve the diagnosis and treatment level of difficult and critical cases,and standardize the diagnosis and treatment behavior to shorten the average hospital stay.