乳腺外科日间医疗项目及预住院运行效果分析  

Effect Analysis of Breast Surgery for Conduct Day Care Program and Pre-Hospital Operation

作　　者：曹蕾[1] 胡波 徐庆峰[1] 杨阳[1] 和融 贾丹丹 李文涛[1] 程剑剑[1] Cao Lei;Hu Bo;Xu Qingfeng;Yang Yang;He Rong;Jia Dandan;Li Wentao;Cheng Jianjian(He’nan Provinicial People’s Hospital,Zhengzhou 450000,He’nan Province,China)

机构地区：[1]河南省人民医院,河南省郑州市450000

出　　处：《中国病案》2021年第4期25-28,共4页Chinese Medical Record

基　　金：河南省软科学研究项目(142400410169)。

摘　　要：目的探讨乳腺外科开展日间医疗项目及预住院后运营效能的变化,为推广日间医疗项目及预住院提供相关参考及科学依据。方法收集2015年1月1日-2016年5月31日乳腺外科推行日间手术、日间化疗及预住院前,及2018年1月1日-2019年5月31日推行后的乳腺外科科室绩效点数、床均结余点数、DRG效能数据、科室运行效能数据、手术结构数据,比较日间医疗项目及预住院推行后的指标变化,其中指标呈正态分布的计量资料采用t检验,分类资料采用卡方检验,运用典型相关分析医疗运行指标和日间医疗项目及预住院开展工作量的整体相关性。结果乳腺外科推行日间医疗项目及预住院后平均每季度绩效点数从53 513提高至80 455,床均结余点数从7419提高至9258,DRG组数从22.8提高至31.8,总权重从648.6提高至1357.9,入院人数从1393.8人次提高至2632.7人次,手术人数从595.0人次提高至952.2人次,手术率从42.7%提高至59.0%,差异具有统计学意义,P<0.05,时间消耗指数从1.13降低至0.60,术前平均住院日从2.27天降低至1.60天,床位使用率从131.3%降低至92.1%,差异具有统计学意义,P<0.05,医疗运行效果指标和日间手术、日间化疗及预住院工作量存在典型相关关系,相关系数=0.990。结论日间医疗项目及预住院的开展可以改善医疗指标,提高医护人员工作积极性和能动性,有效提高科室运行效能,产生良好社会效益,具有推广应用价值。Objective To explore the effect analysis of breast surgery for conduct day care program and routine pre-hospital operation and provide reference and scientific evidences for promote ambulatory surgery, ambulatory chemotherapy and routine pre-hospital operation. Methods Collect bonus points, average bed balance points, DRG performance data, operational efficiency data, surgical structure data of breast surgery from January 1, 2015 to May 31, 2016 before breast surgery conducted day care program and routine pre-hospital operation and data from January 1, 2018 to 2019 May 31 st after breast surgery conducted day care program and routine pre-hospital. Compare the changes of medical indicators of breast surgery, analysis the correlation of medical indicators with ambulatory surgery, ambulatory chemotherapy and routine pre-hospital operation by means of canonical correlation. Results Bonus points raised from 53513 to 80455, average bed balance points raised from 7419 to 9258, DRG group number raised from 22.8 to 31.8, total weight raised from 648.6 to 1357.9, in-patient numbers raised from 1393.8 to 2632.7, operation numbers raised from 595.0 to 952.2, and surgery rate raised from 42.7% to 59.0% after ambulatory surgery, ambulatory chemotherapy and routine pre-hospital operation were performed in breast surgery each quarter(P<0.05). Time consumption index reduced from 1.13 to 0.60, preoperative average length of stay reduced from 2.27 to 1.60, beds rate of utilization of hospital beds reduced from 131.3% to 92.1% after ambulatory surgery, ambulatory chemotherapy and routine pre-hospital operation were performed in breast surgery each quarter(P<0.05), canonical correlation was found between medical indicators of breast surgery and ambulatory surgery, ambulatory chemotherapy and routine pre-hospital operation(correlation index=0.990). Conclusions Ambulatory surgery, ambulatory chemotherapy and routine pre-hospital operation can improve medical index, improve the enthusiasm and initiative of medical staff, advance the eff

关 键 词：乳腺外科 日间手术 日间化疗 预住院 运营效果分析 

分 类 号：R197.1[医药卫生—卫生事业管理]