1506例超长住院日患者影响因素分析

Analysis of Influencing Factors of 1506 Patients with Overlength Hospitalization Days

目的分析某三甲医院超长住院日患者的分布特征和影响因素,为降低平均住院日和提高运营效率提供依据。方法从病案系统导出2022年1月1日-2022年12月31日出院患者病案首页信息共计147186例。将住院日大于等于99%分位数(P99=52天)定义为超长住院日,共1506例。采用二分类Logistic回归分析超长住院日的影响因素。结果全院平均住院日8.80天,超长住院日患者平均住院日87.84天。超长住院日排名前5的科室是康复科、肿瘤内科、神经外科、新生儿科和血液内科,主要疾病分类为循环系统疾病、影响健康状态和与保健机构接触的因素、损伤中毒和外因的某些其他后果、肿瘤、起源于围生期的某些情况、神经系统疾病和呼吸系统疾病。回归分析显示年龄、患者来源、婚姻、入院途径、转科、诊断个数、主要诊断疾病、有无出院后31天内再住院计划、自付费用所占比例是超长住院日的影响因素。结论年龄、患者来源、婚姻状况等多重因素影响超长住院日,医院应对重点科室和疾病实行精准监管,从而缩短平均住院日。

Objectives This study aims to analyze the distribution characteristics and influencing factors of patients with overlength hospitalization days in a tertiary hospital,providing a basis for reducing the average hospitalization days and improving operational efficiency.Methods A total of 147,186 patients'medical record front page information was exported from the medical record system from January 1,2022 to December 31,2022.The hospitalization days greater than or equal to the 99th percentile(P99=52 days)were defined as overlength hospitalization days,with a total of 1506 cases.Binary logistic regression was used to analyze the influencing factors of extremely long hospitalization days.Results The average length of stay in the hospital was 8.80 days,and the average length of stay for patients with overlength hospitalization days was 87.84 days.The top five departments with the longest hospitalization days were rehabilitation department,medical oncology,neurosurgery,neonatology and hematology.The main disease categories were diseases of the circulatory system,factors affecting the state of health and contact with health care facilities,injuries,poisoning and certain other consequences of external causes,tumors,certain conditions originating in the perinatal period,diseases of the nervous system,and diseases of the respiratory system.Regression analysis showed that age,patient source,marriage,admission route,transfer department,number of diagnoses,main diagnosed diseases,whether there was a readmission plan within 31 days after discharge,and the proportion of out-of-pocket expenses were the influencing factors of overlength hospitalization days.Conclusions Multiple patient-associate factors such as age,patient source and marital status affect overlength hospitalization day.Hospitals should implement a precise supervision system for key departments and diseases to shorten the average length of stay.