上海市级医院重点病种31天内重返住院调查与分析  

Investigation and Analysis of Readmission of Major Diseases within 31 Days in Shanghai Municipal Hospitals

作　　者：朱春龙 沈怡[1] 赵爽 张礼 ZHU Chunlong;SHEN Yi;ZHAO Shuang(Shanghai General Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,200080,China)

机构地区：[1]上海交通大学医学院附属第一人民医院,上海200080 [2]市级医院病种质量与安全研究中心,上海200071 [3]上海申康医院发展中心,上海200041

出　　处：《中国卫生质量管理》2023年第3期36-41,共6页Chinese Health Quality Management

基　　金：申康绩效部项目(局级课题)--基于“智慧医务”的市级医院医疗事务管理的优化探索(编号:2020SKMR-36)。

摘　　要：目的了解上海市36家市级医院205个重点病种住院患者31天内重返住院的疾病构成。方法回顾性收集2019年-2021年上海市36家市级医院205个重点病种的病案首页数据,采用Excel软件进行统计,使用描述性方法进行分析。结果分析发现肿瘤、泌尿生殖系统疾病、眼和附器疾病、肌肉骨骼系统和结缔组织疾病占比较高。影响因素包括疾病的严重程度、病理结果、分期手术、对侧器官手术、治疗周期长短等。因相同或相关疾病再住院对于不同的重点病种存在显著差异。结论31天重返不宜直接用于评价医疗质量,因相同或相关疾病再住院的情况亦需结合不同病种进行调整,以此建立非计划重返目录。规范病案首页填写是提升数据质量的关键,不断优化监测指标可以提升重返数据有效性。Objective To investigate the disease composition of readmission within 31 days of 205 major diseases in 36 municipal hospitals in Shanghai.Methods The first page data of medical records of 205 major diseases in 36 municipal hospitals from 2019 to 2021 were collected retrospectively.Excel software was used for statistical analysis and descriptive method was used for analysis.Results Neoplasms,diseases of the genitourinary system,diseases of the eye and adnexa,diseases of the musculoskeletal system and connective tissue accounted for a relatively high proportion.The influencing factors included disease severity,pathological results,staged surgery,contralateral surgery,and the length of treatment cycle.Whether readmission was due to the same or related diseases had significant difference for different key diseases.Conclusion The readmission within 31 days was not suitable for direct evaluation of medical quality,and the readmission due to the same or related diseases should also be adjusted in combination with different diseases,so as to establish the unplanned readmission list.Standardizing the filling of the first page of medical record is the key to improving the data quality.Optimizing the monitoring indicators constantly can improve the effectiveness of readmission data.

关 键 词：市级医院 住院患者 疾病分类 重返住院 医疗质量 病案首页 

分 类 号：R197.323[医药卫生—卫生事业管理]