The Correlation of Hospital Operational Efficiency and Average Length of Stay in China: A Study Based on Provincial Level Data

Objective: To measure the hospital operation efficiency, study the correlation between average length of stay and hospital operation efficiency, analyze the importance of shortening average length of stay to the improvement of the hospital operation efficiency and put forward relevant policy suggestion. Methods: Based on China provincial panel data from 2003 to 2012, the hospital operation efficiencies are calculated using Super Efficiency Data Envelopment Analysis model, and the correlation between average length of stay and hospital operation efficiency is tested using Spearman rank correlation coefficient test. Results: From 2003 to 2012, the average of national hospital operation efficiency was increasing slowly and the hospital operations were inefficient in most of the areas. The national hospital operation efficiency is negatively correlated to the average length of stay. Conclusion: Measures should be taken to set average length of stay in a scientific and reasonable way, improve social and economic benefits based on the improvement of efficiency.

Incidence trends and predictors for cost and average lengths of stay in colorectal cancer surgery

AIM:To evaluate the changing trends and outcomes of colorectal cancer(CRC)surgery performed at a large single institution in Taiwan.METHODS:This study retrospectively analyzed 778patients who received colorectal cancer surgery at E-Da Hospital in Taiwan from 2004 to 2009.These patients were from health examination,inpatient or emergency settings.The following attributes were analyzed in patients who had undergone CRC surgical procedures:gender,age,source,surgical type,tumor number,tumor size,number of lymph node metastasis,pathologic differentiation,chemotherapy,distant metastases,tumor site,tumor stage,average hospitalization cost and average lengths of stay(ALOS).The odds ratio and95%confidence intervals were calculated to assess the relative rate of change.Regression models were employed to predict average hospitalization cost and ALOS.RESULTS:The study sample included 458(58.87%)males and 320(41.13%)females with a mean age of64.53 years(standard deviation,12.33 years;range,28-86 years).The principal patient source came from inpatient and emergency room(96.02%).The principal tumor sites were noted at the sigmoid colon(35.73%)and rectum(30.46%).Most patients exhibited a tumor stage of 2(37.28%)or 3(34.19%).The number of new CRC surgeries performed per 100000 persons was12.21 in 2004 and gradually increased to 17.89 in 2009,representing a change of 46.52%.During the same period,the average hospitalization cost and ALOS decreased from$5303 to$4062 and from 19.7 to 14.4 d,respectively.The following factors were associated with considerably decreased hospital resource utilization:age,source,surgical type,tumor size,tumor site,and tumor stage.CONCLUSION:These results can be generalized to patient populations elsewhere in Taiwan and to other countries with similar patient profiles.

Cost analysis of radical resection of malignant breast tumors under the China Healthcare Security Diagnosis Related Groups payment system

BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.

Surgical treatment of liver cancer and pancreatic cancer under the China Healthcare Security Diagnosis Related Groups payment system

BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers accounted for the highest number of new cases.Real-world data(RWD)is now widely preferred to traditional clinical trials in various fields of medicine and healthcare,as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated.Additionally,research results from the RWD match global reality better than those from traditional clinical trials.AIM To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors.METHODS This study analyzed RWD 1137 cases within the HB1 group(patients who underwent pancreatectomy,hepatectomy,and/or shunt surgery)in 2023.It distinguished different expenditure categories,including medical,nursing,technical,management,drug,and consumable costs.Additionally,it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal–Wallis test.This study used the Steel–Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables.RESULTS The study found that in HB11 and HB13,the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy.Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy,both were significantly longer than those who underwent liver resection.In HB15,no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy;however,both were significantly higher than those in hepatectomy.Additionally,the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection.CONCLUSION China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs.Further research could refine this grouping system and ensure continuous effectiveness and sustainability.

浅析医院平均住院日的计算方法

随着医院综合化程度的日益提高,为考核各临床专科的工作效率,在计算平均住院日时,需考虑转科因素。平均住院日为衡量医院医疗服务效率、工作开展质量水平的重要指标,直接反映了医院资源利用情况及医疗服务整体开展质量水平。当前随着医疗改革的不断深入及医疗需求不断增加,准确计算每位患者的住院日已成为提升医院竞争力、优化医疗资源配置的关键。基于此,本文综述了平均住院日的计算方法、影响因素以及在医院管理中的应用,旨在为医院管理提供参考。

影响术前平均住院日的因素分析与管理对策

背景术前住院日直接影响医院床位资源利用,是衡量医院运营管理水平的重要标志。目的通过回顾一家大型三甲医院数据,全面探讨术前平均住院日的影响因素,为医院缩短术前平均住院日提供可参考的模式。方法通过HIS系统,提取某三甲综合性医院2019年1月1日-12月31日开展的61892例住院择期手术患者临床资料,分析影响术前平均住院日的主要因素。结果大型手术科室、主要手术间手术、大型设备检查、周五入院、临时取消手术等会延长术前住院日;开展日间手术可大幅缩短术前住院日。结论缩短术前住院日涉及管理的多个环节,通过综合施治,全院术前平均住院日有望从4.3 d下降至3.5 d以下。

影响平均住院日的主要因素分析与对策

平均住院日是评价医院效率、医疗质量、管理水平的综合性指标之一。通过对医院近3年来平均住院日等相关核心医疗指标的分析,找出影响医院平均住院日的主要因素,深入研究并提出对策,以便采取科学合理的措施,在确保医疗质量和医疗安全的同时,有效缩短平均住院日,降低患者医疗费用,提高医院的社会效益和经济效益。

医院层面上缩短平均住院日研究进展

笔者介绍了缩短平均住院日的意义,并从医院层面上分析了缩短平均住院日的影响因素,阐述了缩短平均住院日的研究进展,提出了有效缩短平均住院日的具体措施,以供医院管理者在平均住院日管理和研究方面参考。

医院等级评审对平均住院日的影响及意义

目的研究医院等级评审工作对降低医院平均住院日指标的效果,分析其作用和意义。方法收集医院2013年度医疗数据,运用描述性统计学方法、相关性分析和线性回归对一系列迎评医疗管理举措和平均住院日的相关性进行分析。结果住院患者手术比率、出院患者当日出院比率、诊断符合率与平均住院日显示相关关系,线性回归分析具有统计学意义。结论医院等级评审系列工作对平均住院日有显著影响,对提升医院医疗质量建设具有关键导向性作用。

综合医院平均住院日的影响因素分析与对策

目的:通过对某医院8年数据的分析,找出影响平均住院日的主要因素,从而为医院统筹管理,有效地缩短平均住院日,提高医院的效率和效益提供科学合理的依据。方法:运用相关分析、因子分析筛选指标,运用多元回归方法分析得出入选指标的偏回归系数,并结合相关分析结果找出相关性较为显著的指标。结果:正式职工数、两周之内再入院人数比例、危重病人比例等6项指标最终进入多元回归方程。结论:通过多元回归分析,找出平均住院日的主要影响因素,针对影响因素采取合理的措施,缩短平均住院日。缩短平均住院日目的在于充分利用卫生资源,提高医疗质量和医院的综合实力,使医院朝着"质量"、"效率"和"效益"的方向发展。

平均住院日影响因素探析

国内外的研究表明,平均住院日在不同的国家、同一国家的不同地区、同一地区的不同医院、同一医院的不同科室、不同时间段上有很大差异。本文通过国内外文献评阅,从患者因素、医院内部因素、社会因素和其他因素四个方面对影响平均住院日的因素进行了综述,为我国医院管理者和研究者研究如何缩短平均住院日、提高医院效率提供系统的理论框架。

三级综合医院患者长期住院影响因素分析及对策

对三级综合医院长期住院患者影响因素进行分析有利于缩短平均住院日,优化优势医疗资源,缓解大医院"看病难"的问题。通过对三级综合医院患者长期住院进行了实证研究,分析了其影响因素,并提出了构建长期照护体系、加强双向转诊、优化医院管理等相关政策建议。

47所大型综合医院2008年平均住院日影响因素研究

目的:研究47所三级甲等综合医院2008年平均住院日的影响因素。方法:收集了国内47所三级甲等综合医院2008年的相关数据,运用描述性统计分析和多元线性回归分析找出影响平均住院日的显著因素。结果:出院人数、实际开放床位数、副主任及以上医师比例对平均住院日有显著性影响。结论:医院所属区域的经济发展水平、医院科室床位配置等变量对医院平均住院日没有显著性影响。

医院管理中平均住院日影响因素的研究

平均住院日是评价医院工作效率和效益、医疗护理工作质量和技术水平的综合指标,合理缩短平均住院日在一定程度上反映了医院医疗水平的提高。本文主要对2002—2009上半年北京朝阳医院出院病人平均住院日进行分析,探讨医院管理中影响平均住院日的主要因素及合理降低平均住院日的相应措施,从而为提高医院的整体经济效益和社会效益提供借鉴。

三级综合医院患者无效住院日影响因素研究

目的分析患者无效住院日影响因素,降低无效住院天数,减轻患者负担,提高三级综合医院服务效率和质量。方法采用文献分析法选取三级综合患者无效住院日影响因素指标集,运用德尔菲法构建三级综合医院患者无效住院日影响指标体系。结果参与咨询的专家权威程度平均为0.868 3,通过两轮专家咨询,最终得出21个三级综合医院患者无效住院日影响因素,其中医方11个、患方6个、社会方面4个。结论将患者无效住院日影响因素分为医方、患方、社会三个层面,针对不同影响因素,采取应对策略,最终提高医疗资源利用效率,降低患者住院经济负担。

某三甲医院鼻咽癌放疗患者平均住院日影响因素的研究

目的：结合住院流程，分析影响接受放射治疗的鼻咽癌患者平均住院日的因素，为进一步缩短平均住院日提供思路。方法以我院2012年12月-2013年12月收治的205名接受放射治疗的鼻咽癌患者为研究对象，收集患者的临床资料，采用 SPSS20.0软件建立数据库并进行统计分析。结果患者确诊天数、待放疗天数、放疗天数、放疗后住院日对平均住院日的影响具有统计学意义，放疗后并发症对平均住院日的影响无统计学意义。结论优化诊疗流程，提高专业水平，迅速明确诊断及治疗方案，增强诊疗活动的计划性与合理性，加强科室间的协作有助于缩短鼻咽癌放疗病人的平均住院日。

16所大型综合医院2000～2008年平均住院日影响因素研究

目的:研究16所三级甲等综合医院2000～2008年平均住院日的影响因素。方法:收集了国内16所三级甲等综合医院2000～2008年的相关数据,运用描述性统计分析、相关分析和多元线性回归分析找出影响平均住院日的显著因素。结果:出院人数/卫技人员数、卫技人员数/床位数、在岗职工实际人数、实际开放床位数、固定资产、急诊抢救成功率、CT台数以及Y08对平均住院日有显著性影响。结论:启动"缩短平均住院日,提供医疗服务效能"项目后,各医院缩短平均住院日效果显著。

某三级综合医院超长住院日患者的影响因素分析及应对策略

目的为合理控制住院时间,使有限的医疗资源服务更多患者,本研究分析某三级综合医院超长住院日患者分布特征及影响因素,探索应对策略。方法统计分析医院2015—2018年住院时间大于60 d的超长住院日患者的分布特征。结果超长住院日患者中男性占比高于女性;超长住院日患者的产生与年龄因素相关,越高龄的年龄组占比越多;费用类别构成中,医保及公费医疗患者占绝大多数;病种的构成中,循环系统疾病与呼吸系统疾病患者占超长住院日患者的半数以上。结论加强重点科室及疾病的患者管理、把握医疗质量关键环节、深入沟通及告知、防控医疗风险减少医患纠纷、加强医联体建设是控制住院时间延长的有效途径。

浅析医院平均住院日的影响因素

影响平均住院日的因素很多,有医院内部因素,也有医院外部因素包括诸如国家医保政策、患者因素等医院不可控因素;该文主要就医院内部管理层面影响平均住院日的因素进行分析,这些因素可以通过医院自身采取措施得以调控,从而达到缩短平均住院日的目的。

缺血性心脏病住院费用与住院日影响因素分析

目的将北京市2007—2009年收治的缺血性心脏病的3个病种患者作为对象进行研究,以期为合理控制医疗费用提供决策依据。方法采用回顾性调查方法,用SPSS18.0统计软件,采用单因素统计方法对数据进行分析。结果研究结果显示,医院级别、付费方式、性别、年龄和治疗方式对平均住院日和例均住院费用有影响,2007—2009年缺血性心脏病的3个病种平均住院日呈下降趋势,手术费、治疗费和药费增长幅度较大。结论通过加强医院管理,完善双向转诊制度,推行DRGs,实施临床路径,根据病情选择适宜的治疗方式等措施,可实现缩短平均住院日、降低医疗费用的目的。同时要进一步提高医疗保障水平,降低患者自付比例,最大限度地减轻患者负担。