某三甲医院骨科患者术前等待时间及影响因素分析  

Factors Associated with Surgery Waiting Time among Patients Admitted to the Department of Orthopedics of a Tertiary Hospital

作　　者：姜若 罗莉[1,2] 刘义成 黄阿红[1] 胡承方 JIANG Ruo;LUO Li;LIU Yi-cheng(Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai,200233,China)

机构地区：[1]上海交通大学附属第六人民医院,上海200233 [2]上海交通大学中国医院发展研究院医院运营研究所,上海200233 [3]上海交通大学中国医院发展研究院公立医院党建研究所,上海200233

出　　处：《中国医院管理》2021年第11期44-47,共4页Chinese Hospital Management

基　　金：上海交通大学中国医院发展研究院建设地方高水平大学医院管理专项(CHDI-2019-C-05)。

摘　　要：目的了解上海市某三甲医院骨科患者手术前等待时间及影响因素。方法从2019年某三甲医院骨科患者病案首页获取人口学信息、疾病相关信息以及手术信息。采用多元线性回归结合AIC原则筛选影响因素,并利用广义提升回归模型(GBM)对影响因素相对重要性进行排名。结果分析共计纳入25532名患者。手术等待时间中位数(四分位范围)为2(2,3)天。经变量筛选,亚专科、入院途径、患者来源、年龄、付费类型、婚姻、民族以及性别8个变量被纳入最终模型;除民族外,其他7个变量均为显著影响因素(P<0.05)。GBM模型显示,亚专科、年龄和入院途径的相对重要性排在前三位。其中,肿瘤亚专科患者平均手术等待时间最高,脊柱亚专科患者平均手术等待时间最低(P<0.001);随着患者年龄升高,手术等待时间也升高(P<0.05);相较于通过急诊入院的患者,门诊入院的患者手术等待时间更低(P<0.05)。结论合理缩短术前等待时间能有效提升医疗质量和医疗效率,应多途径缩短患者术前等待时间。Objective To explore surgery waiting time and associated factors among patients admitted to the department of orthopedics of a tertiary hospital in Shanghai.Methods Data on patients’demographics of a tertiary hospital,disease,and surgery information were collected from the front page of the medical record of patients in2019.Multiple linear regression combined with the AIC principle is used to screen the influencing factors,and the generalized promotion regression model(GBM)is used to rank the relative importance of the influencing factors.Results A total of 25532 patients were included in the final analysis.The median surgery waiting time was 2(2~3)days.After variable screening,8 variables including subspecialty,admission route,patient source,age,payment type,marriage,ethnicity,and gender were included in the final model;except for ethnicity,the other seven variables were all significant influencing factors(P<0.05).GBM model showed that subspecialty,age and admission department were the top three factors regarding relative importance.Surgery waiting time of patients of the Subspecialty of oncology was the highest and that of the Sub-specialty of spinal was the lowest(P<0.001)among all Sub-specialties;the waiting time was increased with the increasing age(P<0.05);the waiting time of patients admitted via outpatient department was lower than that via the emergency department(P<0.05).Conclusion Reducing pre-surgery waiting time may contribute to the improvement in quality and efficiency of health care.Hence,multiple measures should be developed to reduce pre-surgery waiting time for patients.

关 键 词：骨科 手术 等待时间 影响因素 

分 类 号：R197.323.2[医药卫生—卫生事业管理]