北京市某医院超长住院患者分布特征及影响因素分析  

Analysis of distribution characteristics and influencing factors of inpatients with super long hospitalizationg days in a hospital in Beijing

作　　者：张志丽[1] 曲金宁 王璐[1] 张月宁[1] Zhang Zhili;Qu Jinning;Wang Lu;Zhang Yuening(Medical department,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;Department of Orthopedics and Traumatology,Guangwai Hospital of Xicheng District,Beijing 100055,China)

机构地区：[1]首都医科大学附属北京佑安医院,北京100069 [2]北京市西城区广外医院,北京100055

出　　处：《首都食品与医药》2022年第22期93-96,共4页Capital Food Medicine

摘　　要：目的 通过分析北京某院超长住院患者分布情况及其影响因素,探讨解决方案.方法 检索2020年9月1日-2021年8月31日期间住院患者18810人次的病案首页资料,将住院日超过出院患者住院日的99%分位数(P99=48天)定义为超长住院日,共198例,进行回归分析.结果 超长住院患者人数占全院总出院人数1.05%,以"48天-57天"最多,占50.5%;年龄以"51岁-60岁"最多,占33.84%.疾病类别前五位分别是消化系统疾病、肿瘤、感染性疾病、泌尿生殖系统疾病、呼吸系统疾病;住院科室前五位依次是肝病内科、普通外科、感染科、肿瘤内科和介入科;性别、年龄、住院次数、转科、入院途径、付费方式、手术操作、呼吸机的使用、病种、入院科室、离院方式是超长住院日的影响因素;logistic回归分析显示,急诊入院、转科、手术操作、离院方式(死亡)、普外科和感染科住院(相对于肝病内科)是住院患者发生超长住院的影响因素.结论 医院应对重点科室、重点病种加强管理,规范化诊疗,严把质控关,减少超长住院患者,缩短平均住院日.Objective To explore solutions by analyzing the distribution characteristics and influencing factors of inpatients with super long hospitaliza tion days in a hospital in Beijing.Methods The medical records of 18,810 inpatients from September 1,2020 to August 31,2021 were retrieved.The hospital stay exceeding 99%quantile(Pog=48days)of the hospital stay of discharged patient was defined as the extremely long hospital stay.There were 198 cases in total and regression model was used for factors analysis.Results Inpatients with super long hospitalizationg days accounted for 1.05%,"48 days to 57 days"were the most,accounting for 50.5%,in the group aged 51-60 were the most,accounting for 33.84%.The top five disease categories are digestive system diseases,tumors,infectious diseases,genitourinary system diseases,and respiratory system diseases;the top five inpatient departments are liver diseases department,general surgery department,infectious diseases department,medical oncology departmentand interventional departments;gender,Age,frequencies of hospitalization,inter-department transfer,admission route,payment method,operation,useing of ventilator,disease type,admission department,and discharge method were the influencing factors of super long hospitalization days;Logistic regression analysis showed that male,emergency admission,inter-department transfer,operation,mode of discharge(death),general surgery and infectious disease hospitalizations(vs.hepatology department)were influencing factors for prolonging hospital stay in hospitalized patients.Conclusion The hospital should strengthen the management of key departments and diseases,standardize the diagnosis and treatment,strictly control the quality control,reduce super long hospitalization days,and shorten the average hospitalizationdays.

关 键 词：超长住院 分布特征 影响因素 LOGISTIC回归分析 平均住院日 

分 类 号：R197.3[医药卫生—卫生事业管理]