2826例住院超30天患者影响因素分析

Analysis of Influencing Factors in 2826 Patients Hospitalized for more than 30 Days

目的 分析某医院住院超30天患者分布特征及其影响因素,为缩短平均住院日提供参考。方法收集2017年1月1日-2021年12月31日某院出院患者住院病案首页数据共204170例,应用Excel对检索导出的数据进行整理、分类,对其中超30天住院日患者的分布特征进行统计描述;采用χ^(2)检验比较患者基本情况,采用多因素logistic回归模型分析超30天住院日患者住院期间可干预的影响因素。结果 该院住院日超30天患者共2826例;超30天患者住院中位数为40天;住院天数集中在31~40天、41~50天,分别占比50.57%和25.12%;年龄主要为老年人(构成占比为53.26%)。出院科室前五位依次是肿瘤科、骨科、神经外科、康复医学科、普通外科;疾病类别前五位分别是影响健康状态和与保健机构接触的因素(Z00-Z99)、损伤、中毒和外因的某些其他后果(S00-T98)、循环系统疾病(I00-I99)、肿瘤(C00-D48)、呼吸系统疾病(J00-J99)。多因素Logistic回归分析显示转科、疑难危重、手术、院内感染、合并症数量、DIP实施是住院超30天的重要影响因素。结论 患者住院期间转科、疑难危重、手术、发生院内感染、多个合并症等均增加超长住院风险;医院应加强医疗质量管理,减少超30天住院患者数量、缩短平均住院日。

Objectives To analyze the distribution characteristics and influencing factors of patients with over 30-days in a hospital,and provide references for shortening the average length of stay.Methods From January 1st,2017 to December 31st,2021,the front page data of 204,170 discharged patients from a hospital were collected.Excel was used to sort and classify the retrieved data,and the distribution characteristics of patients who stayed in hospital for more than 30 days were statistically described.χ^(2) test was used to compare the basic condition of patients,and multiple logistic regression model was used to analyze the influence factors of intervention during hospitalization of patients with more than 30 days.Results 204170 patients were discharged from the hospital from 2017 to 2021.Among them,2,826 patients were hospitalized for more than 30 days,accounting for 1.38%,the median of stay over 30 days was 40 days.The days of hospitalization were 31-40 days and 41-50 days,accounting for 50.57%and 25.12%respectively.Age mainly distributed in the elderly with the proposition of 53.26%.The top five discharge departments were department of Oncology,Orthopaedics,Neurosurgery,Rehabilitation Medicine and General Surgery.The top five disease categories were health status and exposure to health facilities(Z00-Z99),injury,poisoning and some other consequences of external causes(S00-T98),cardiovascular disease(I00-I99),tumor(C00-D48)and respiratory diseases(J00-J99).The regression results showed that transferred,difficult and serious,surgery,hospital infection,multiple complications,types of medical insurance were the important influencing factors of over 30 days hospitalization.Conclusions During the period of hospitalization,patients transferred,difficult and serious,surgery,hospital infection,multiple complications would increase the risk of long-term hospitalization.The hospital should strengthen the management of medical quality in the process to reduce the number of patients over 30 days and to shorten the average length of stay.