日间手术对平均住院日影响的中断时间序列分析

Interrupted time⁃series analysis of effect of day surgery on average length of hospital stay

目的 探讨日间手术的实施对医院平均住院日的影响。方法 从湖北省某三甲医院日间手术管理系统中调取全院、泌尿外科、眼科及耳鼻喉头颈外科2013年1月至2019年12月的平均住院日数据,采用中断时间序列模型分析日间手术实施前后各科室平均住院日的变化趋势。结果 日间手术的实施使全院、泌尿外科、眼科及耳鼻喉头颈外科平均住院日分别下降1.665 d(P<0.05)、3.501 d(P<0.05)、2.840 d(P<0.05)和5.767 d(P<0.05),其中,日间手术前平均每月分别下降0.026 d(P<0.05)、0.001 d(P=0.856)、0.004 d(P=0.425)和-0.005 d(P=0.383),日间手术后下降幅度分别增加了0.030 d(P<0.05)、0.073 d(P<0.05)、0.058 d(P<0.05)和0.104 d(P<0.05)。结论日间手术的实施可有效缩短平均住院日,提高医疗资源利用率。

Objective To explore the effect of implementation of day surgery on average length of hospital stay.Methods The data of average length of hospital stay in the entire hospital,Department of Urology,Department of Ophthalmology,and Department of Otolaryngology,Head and Neck Surgery from January 2013 to December 2019 were retrieved from the day surgery management system of a Hubei ClassⅢLevel A Hospital.Interrupted time⁃series model was used to analyze the change trend of average length of hospital stay of various departments before and after the implementation of day surgery.Results The implementation of day surgery resulted in a decrease of average length of hospital stay in 1.665 days(P<0.05),3.501 days(P<0.05),2.840 days(P<0.05),and 5.767 days(P<0.05)in the entire hospital,Department of Urology,Department of Ophthalmology,and Department of Otolaryngology,Head and Neck Surgery,respectively,therein the average monthly decrease before day surgery was 0.026 days(P<0.05),0.001 days(P=0.856),0.004 days(P=0.425),and-0.005 days(P=0.383),respectively.The rate of decrease after day surgery increased by 0.030 days(P<0.05),0.073 days(P<0.05),0.058 days(P<0.05),and 0.104 days(P<0.05),respectively.Conclusions The implementation of day surgery can effectively shorten the average length of hospital stay,and improve the utilization of medical resources.