某三级综合医院日间手术实施现状  

Current status of day surgery in a tertiary general hospital

作　　者：王莹 刘琰[2] 孙辉 Wang Ying;Liu Yan;Sun Hui(National Health Commission Hospital Management Institute,Beijing,100044;不详)

机构地区：[1]国家卫生健康委医院管理研究所,北京市100044 [2]中华中医药学会,北京市100029

出　　处：《中国病案》2022年第11期81-84,共4页Chinese Medical Record

摘　　要：目的分析某三级综合医院全年日间手术实施现状,为下一步进行相关研究提供参考和基线数据。方法通过医院信息系统采集2019年1月1日-2019年12月31日日间手术患者病案首页数据共11616例,剔除不适用数据,保留有效数据量11371例;采用Excel建立数据库,对日间手术患者基本情况采用频数、率等指标进行描述性分析;对于日间手术患者费用的影响因素采用SAS 9.4统计软件进行单因素分析和回归模型拟合。结果某院开展的日间手术病种以普通外科的疾病为主,其中乳腺类疾病患者占比最高,占到日间手术总人数的22.06%;日间手术二级、三级手术,分别占到总手术量的44%和38%;77.44%的日间手术患者年龄为15~59岁,其中女性患者占62.66%,男性患者占37.34%;日间手术患者总费用均数为7985.17元,其中耗材费占比最大;对患者手术费用产生影响的费用构成包括手术级别、医保支付方式、年龄、性别、门(急)诊诊断和和出院主要诊断一致性指标,回归方程为Y=3.295+0.217X4-0.011X6+0.068X3-0.001X2-0.012X1。结论日间手术常运用于手术难度适中的常见病和多发病,服务人群多为中青年患者,日间手术的发展离不开完善的结算流程和医保政策;鼓励日间医疗的同时,要加强医用耗材成本的控制,以提高其经济效益。Objectives This study aims to analyze the current status of day surgery in a tertiary general hospital,and to provide reference and baseline data for further related research.Methods A total of 11616 pieces of data from January 1,2019 to December 31,2020 were collected from the hospital information system,and 11371 pieces of valid data were retained after removing unsuitable data.Excel was used to establish a database,and frequency,rate and other indicators were used to make a descriptive analysis of the basic conditions of patients undergoing daytime surgery.SAS 9.4 statistical software was used to conduct univariate analysis and regression model fitting for influencing factors of the expenses of patients undergoing day surgery.Results At present,the day surgery diseases carried out by the hospital are mainly diseases of general surgery.The patients with breast diseases accounted for 22.06%of the total number of daytime surgeries,accounting for the highest proportion.The surgical level was mostly secondary or tertiary,accounting for 44%and 38%of the total operation volume.77.44%of the day surgery patients were aged 15-59 years old,including 62.66%female patients and 37.34%male patients.The average of the consumables and treatment cost was 7985.17 Yuan,which accounted for the largest proportion in the total cost of patients undergoing daytime surgery.Factors affecting the total cost include surgical grade,medical insurance payment method,age,gender,primary diagnostic consistency index of outpatient(urgent)diagnosis and discharge,and the regression equation was Y=3.295+0.217X4-0.011X6+0.068X3-0.001X2-0.012X1.Conclusions Daytime surgery was mainly for common diseases and frequently occurring diseases and was more suitable for young and middle-aged people.The long-term development of day surgery is inseparable from perfect settlement process and medical insurance policy.At the same time,the cost control of medical consumables should be strengthened to improve the economic benefit.

关 键 词：日间手术 实施 现状 

分 类 号：R197.323[医药卫生—卫生事业管理]