[1]明星辰 方孝梅 罗勤 付萍 邓琼 吴平勇 杨骁.3 574例超长住院日病例分析与改进建议[J].中国卫生质量管理,2017,24(04):025-28.[doi:10.13912/j.cnki.chqm.2017.24.4.10]
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3 574例超长住院日病例分析与改进建议
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第24卷
期数:
2017年04期
页码:
025-28
栏目:
医疗质量
出版日期:
2017-07-28

文章信息/Info

作者:
明星辰 方孝梅 罗勤 付萍 邓琼 吴平勇 杨骁
十堰市太和医院（湖北医药学院附属医院）
关键词:
住院患者; 超长住院日; 病例
Keywords:
Inpatients;  Long Length of Stay;  Cases
DOI:
10.13912/j.cnki.chqm.2017.24.4.10
摘要:
目的分析综合医院超长住院病例现状，为有效预防或控制超长住院日提供决策支持。方法从某三级甲等综合医院住院病案首页中获取住院日≥30天的病例资料，采用 Microsoft Excel、SPSS Statistics 19.0进行分析。结果超长住院患者占出院总人数的2.9%，使全院平均住院日延长了1.36天；超长住院天数以“30天～44天”最多，占68.94%；城镇职工医保、全自费和新农合的付费方式占比最大；81.20%的超长住院病例伴随有其他疾病；38.97%的超长住院病例术前住院天数大于或等于10天；疾病构成排名前5位的是损伤、中毒和外因的某些其他后果以及循环系统疾病、肌肉骨骼系统和结缔组织疾病、肿瘤、影响健康状态和与保健机构接触的因素。结论应落实医疗核心制度，提高工作效率；完善质控标准和诊疗流程，全面开展临床路径；关注医疗负性指标，建立预警报告制度；加强部门协调，逐步推行日间手术；建立医疗联合体，落实双向转诊。
Abstract:
ObjectiveTo analyze the status of long length of stay in general hospitals, and to provide decision support for effective prevention or control of long length of stay. MethodsThe data of inpatients with length of stay ≥30 days were obtained from the homepage of medical records in a three-level general hospital. The data were analyzed by Microsoft Excel and SPSS Statistics 19.0. ResultsThe number of inpatients with long length of stay accounted for 2.9% of the total number of discharged patients, which made the average length of stay extended 1.36 days. The maximum frequency among inpatients with long length of stay was "30 to 44 days" with proposition of 68.94%. The most proposition of paying measures were urban workers health insurance, all at his own expense, and new rural cooperative medical system (NCMS). 81.20% of the long length of stay cases accompanied by other diseases; 38.97% of the long length of stay cases had more than 10 preoperational days. The top five compositions of diseases were damage, poisoning and certain other consequences by external causes, circulatory system diseases, musculoskeletal and connective tissue disorders, tumors, factors affecting health status and exposure to health care institutions. ConclusionThe medical core systems should be implemented, the efficiency of medical work should be improved; the quality control standards and diagnosis and treatment process should be improved, clinical path can be comprehensively performed; medical negative indicators should be focused on, and the early warning reporting system should be established; departmental coordination should be strengthened with the progressive implementation of daytime surgery; the establishment of medical consortium and the implementation of two-way referral.

参考文献/References:

［1］聂静,刘佳.超长住院日患者分布特征与影响因素分析［J］.中国医院管理，2015,35(8):44-46.

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更新日期/Last Update: 2017-07-28