利用病例对照研究对非计划再次手术进行质量评价  

Quality evaluation of unplanned reoperation by case-control study

作　　者：吴小娟[1] 赵庆祥[2] 曲巍[1] 石斗飞[1] 徐天和[3] Wu Xiaojuan;Zhao Qingxiang;Qu Wei;Shi Doufei;Xu Tianhe(Quality Management Office,Binzhou Medical University Hospital,Binzhou 256603,China;Pain Medicine,Binzhou Medical University Hospital;Binzhou Medical University)

机构地区：[1]滨州医学院附属医院质量管理办公室,256603 [2]滨州医学院附属医院疼痛科 [3]滨州医学院

出　　处：《中国医院统计》2019年第5期383-385,共3页Chinese Journal of Hospital Statistics

摘　　要：目的 对某医院非计划再次手术发生的情况进行分析,探讨其对医院医疗质量的影响,为制定提高医疗质量措施提供参考。方法 收集某医院2014—2017年发生的非计划再次手术患者信息,总结发生原因,利用病例对照研究对非计划再次手术进行质量评价。结果 2014—2017年,某医院共开展住院手术122 396例,其中非计划再次手术169例,发生率为0.14%。非计划再次手术前5位原因为:术后出血(96例,56.80%)、术后切口感染(22例,13.02%)、未达到手术效果(13例,7.69%)、术后脑水肿(10例,5.92%)、术后吻合口瘘(7例,4.14%);与对照组相比,非计划再次手术可延长患者平均住院日,增加平均住院费用、药费、耗材费、药占比(P<0.05)。结论 医院应加强对非计划再次手术的管理,针对手术中存在的问题进行改进,提高医院的医疗质量。Objective To analyze the occurrence of unplanned reoperation,and explore the influence on medical quality,in order to provide measures for improving medical quality.Methods The information of unplanned reoperation patients in our hospital from 2014 to 2017 was collected,the causes of reoperation were analyzed,and the impact of unplanned reoperation on medical quality index was explored by case-control study.Results From 2014 to 2017,there were 122396 inpatient surgery cases in the hospital,including 169 unplanned reoperations,with an incidence of 0.14%.The main reasons of the unplanned reoperations included postoperative bleeding(96 cases,56.80%),incision infection(22 cases,13.02%),failure to reach the effect of surgery(13 cases,7.69%),postoperative hematoma(10 cases,5.92%),and postoperative cerebral edema(7 cases,4.14%).Compared to the control group,unplanned reoperation could prolong the average days of hospitalization,increase hospitalization costs,drug costs,material consumables,and drug proportion(P<0.05).Conclusion Hospitals should strengthen the management of unplanned reoperations,aim at the existing problems in the operations and improve the medical quality of our hospital.

关 键 词：非计划再次手术 医疗质量 病例对照研究 

分 类 号：R195.1[医药卫生—卫生统计学]