山西省某三甲综合医院超长住院时间老年患者分布特征及影响因素分析

Distribution Characteristics and Influencing Factors of Elderly Patients with Super-long Hospital Stay in a Three A and Tertiary Hospital in Shanxi

目的分析超长住院时间老年患者分布特征及影响因素,为缩短住院时间提出解决措施。方法采用回顾性调查病例的方法,选取2017年-2021年住院时间超过30天的60岁及以上老年患者共计3850例的住院病案首页信息,分析超长时间住院老年患者的特征;采用多元线性回归分析超长住院老年患者住院时间的影响因素。结果超长住院时间老年患者男性多于女性,平均年龄70.35岁,平均住院费用9.51万元;住院天数主要集中在30天-39天,主要分布在放疗科,所患疾病首位为肿瘤;骨科超长时间住院老年患者平均住院时间最长,合并症数量6-10种的患者占比最高,某些传染病和寄生虫病患者住院时间最长,死亡患者平均住院时间最长。不同性别、出院31天内有无再住院计划差异均无统计学意义(P>0.05)。不同年龄、住院次数、入院途径、是否转科、入院情况、是否药物过敏、手术次数、是否临床路径、是否危重、是否抢救、合并症数量、支付方式、是否合并肿瘤,差异有统计学意义(P<0.05)。结论线性回归结果显示,住院次数、是否过敏、是否临床路径、是否抢救是老年患者住院时间长短的影响因素。通过加强重点科室和重点病种的监管、关注患者自身状况、建立临床路径等方式,减少老年患者住院时间。

Objectives To analyze the distribution characteristics and influencing factors of elderly patients with super-long hospital stay,and put forward solutions to shorten the hospital stay.Methods By retrospective investigation,3850 cases of elderly patients aged 60 years and above who were hospitalized for more than 30 days from 2017 to 2021 were selected from the front page of hospitalization records to analyze the characteristics of elderly patients hospitalized for very long periods of time.Multiple linear regression was used to analyze the factors influencing the length of hospital stay in elderly patients.Results The elderly patients with very long hospital stay were more male than female,with an average age of 70.35 years old and an average hospital cost of 95,100 yuan.The hospitalization days were mainly concentrated in 30-39 days,mainly distributed in the department of radiotherapy,and the first disease was tumor.The average length of hospitalization stay of elderly patients with super-long hospitalization stay in orthopedics was the longest,the proportion of patients with 6-10 kinds of complications was the highest,the length of hospital stay of patients with certain infectious diseases and parasitic diseases was the longest,and the average length of hospital stay of patients with death was the longest.There were no significant differences in gender and re-hospitalization plan within 31 days after discharge(P>0.05).There were statistically significant differences in age,number of hospitalizations,route of admission,department transfer,condition of admission,drug allergy,number of operations,clinical path,critical condition,rescue condition,number of complications,payment method,and tumor combination(P<0.05).Conclusions Linear regression results showed that the number of hospitalizations,allergy,clinical pathway and rescue were the factors influencing the length of hospital stay of elderly patients.By strengthening the supervision of key departments and key diseases,paying attention to patients'own conditions and establishing clinical pathways,the hospital stay of elderly patients could be reduced.