出院患者非计划再入院影响因素分析  

Analysis of Influencing Factors of Unplanned Re-Admission of Discharged Patients

作　　者：申良荣[1] 张鸿雁[1] 孙忠民[1] 高建民[2] SHEN Liangrong;ZHANG Hongyan;SUN Zhongmin(First Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an,Shaanxi,710061,China)

机构地区：[1]西安交通大学第一附属医院,陕西西安710061 [2]西安交通大学公共政策与管理学院,陕西西安710061

出　　处：《中国卫生质量管理》2018年第5期35-38,共4页Chinese Health Quality Management

基　　金：陕西省国际科技合作与交流计划项目"大型三甲医院健全高危物品管理体系的研究"(2014KW26)

摘　　要：目的了解出院患者非计划再入院的影响因素。方法采用SPSS 19.0统计软件对某大型公立医院2014年出院患者病案首页资料数据进行描述性分析,分为研究组(非计划再入院组)和对照组进行对比研究。结果非计划再入院的前15位病例的再入院率为12.81%,疾病以慢性或难治性疾病为主,再入院发生率较高的前3个科室是肿瘤放疗科、感染性疾病科、脑病科。研究组合并1种疾病患者的比例(40.0%)高于对照组(28.3%),而无合并疾病患者的比例(15.5%)低于对照组(21.6%)。有术后并发症病例的非计划再入院率(6.02%)高于无术后并发症病例(3.28%)。住院期间未发生医院感染病例的非计划再入院率(6.41%)高于发生医院感染病例(4.28%)。不同付费方式中,新型农村合作医疗病例的非计划再入院率最高(7.01%),商业医疗保险病例的再入院率最低(1.91%)。结论非计划再入院率是医疗服务质量的体现,患者再入院以慢性病为主,合并疾病数量、医保政策导向对再入院有影响。应优化医疗机构资源配置,针对不同病种进行深入分析,结合医疗统计数据采取适当监管手段,制定合理医疗指标,降低非计划再入院率。Objective To analyze the factors affecting the unplanned re-admission of the discharged patients. Methods The home page information of the medical records of discharged patients in a large-scale public hospital in 2014 was analyzed by SPSS 19.0 software for descriptive analysis between the unplanned re-admission group and the control group. Results The unplanned re-admission rate of cases with the top-fifteen principal diagnosis of readmission was 12.81%. The diseases mainly included chronic and refractory diseases, which distributed mainly in the Department of Radiation Oncology, Department of Infectious Diseases, and Department of Encephalopathy ＆ Neurology. The proportion of the patients with one kind of combined diseases in the study group is 40.0% which was higher than that of the control group of 28.3%, while the proportion of patients without others disease in the study group was 15.5% which was lower than that of the control group of 21.6%. The unplanned readmission rate （6.02%） of patients with postoperative complications was higher than that of patients without postoperative complications （3.28%）. The unplanned readmission rate （6.41%） of patients without nosocomial infection during hospitalization was higher than that of patients with nosocomial infection （4.28%）. Among the different payment methods, the unplanned re-admission rate of cases with New Rural Cooperative Medical System was the highest （7.01%）, and the rate of those with commercial medical insurance was the lowest （1.91%）. Conclusion The unplanned readmission rate is the reflection of the quality of medical services. Patients were mainly re-admitted with chronic diseases, and the combination of the number of diseases and the policy orientation of medical insurance had an impact on the readmission rate. It should optimize the allocation of resources of medical institutions, make in-depth analysis of different diseases, take appropriate regulatory measures in combination with medical statistics data, formul

关 键 词：出院患者 非计划再入院 诊断 影响因素 

分 类 号：R197.323[医药卫生—卫生事业管理]