武汉市某三级医院超长住院日患者分布特征和影响因素分析  

Analysis of Distribution Characteristics and Influencing Factors of Patients with Excessively Long Hospital Stays in a Tertiary Hospital in Wuhan

作　　者：张灵丽 洪英 付琳娜 吴钟昊 杨鹏宇 李进 梁晓明 Zhang Lingli;Hong Ying;Fu Linna;Wu Zhonghao;Yang Pengyu;Li Jin;Liang Xiaoming(Central Theater Command General Hospital of PLA,Wuhan 430000,Province,China;不详)

机构地区：[1]中国人民解放军中部战区总医院,武汉市430000

出　　处：《中国病案》2024年第9期57-61,共5页Chinese Medical Record

摘　　要：目的探讨武汉市某三级医院超长住院日住院患者费用构成及其影响因素,为缩短平均住院日、合理利用医疗资源提供参考借鉴。方法对武汉市某三级医院2022年1月1日-2022年12月31日期间3404例出院患者的超长住院日分布特征进行统计描述,超长住院日的选择条件为住院天数≥30天的患者,运用Logistic回归模型分析其影响因素。结果超长住院日出院3404人次,占比5.32%,超长住院患者中平均年龄(64.86±10.79)岁,最小1岁,最大105岁。超长住院患者中老年科、神经外科占比最高,分别为43.86%和16.28%,前10位超长住院日科室累计构成比为59.34%。疾病分布中循环系统疾病和呼吸系统疾患者数最多,分别为680人次和487人次。回归分析显示影响超长住院的因素依次为是否危重、年龄、性别、疾病转归和手术级别。同时通过二分类Logistic回归系数可知影响因素中的是否危重对超长住院日影响最大,且具有统计学意义。结论超长住院日会延长医院平均住院日,造成医疗资源的浪费和社会资源紧张。医院在加强双向转诊,全面落实核心制度的前提下,要有效控制超长住院日天数和患者数量,有效提高医疗运营效率。Objectives The purpose of this study is to explore the composition and influencing factors of hospitalization costs for patients with excessive length of stay in a tertiary hospital in Wuhan,in order to provide a reference for shortening the average length of stay and rationally utilizing the medical resources.Methods A statistical description was conducted on the distribution characteristics of ultra long hospital stay days of 3,404 discharged patients from a tertiary hospital in Wuhan from January 1 to December 31,2022.The selection criteria for excessively long hospital stays were patients with hospital stays≥30 days.Logistic regression models were used to analyze the influencing factors.Results 3404 patients had prolonged hospitalization,accounting for 5.32%.The average age of patients with prolonged hospitalization was 64.86±10.79 years old,with a minimum age of 1 year and a maximum age of 105 years old.Among patients with long hospital stays,geriatrics and neurosurgery have the highest proportion,accounting for 43.86%and 16.28%respectively.The cumulative proportion of departments in the top 10 long hospital stays was 59.34%.In terms of disease distribution,the number of patients with circulatory system diseases and respiratory system diseases was the largest,at 680 and 487 respectively.Regression analysis showed that the factors affecting excessively long hospitalization were critical illness,age,gender,disease outcome,and surgical level.At the same time,the binary logistic regression coefficient showed that critical illness or not had the greatest impact on excessive hospital stays,and the data were statistically significant.Conclusions Excessive length of hospital stay can prolong the average length of hospital stay,resulting in wastage of medical resources and a shortage of social resources.Under the premise of strengthening two-way referral and fully implementing the core system,hospitals should effectively control the length of stay and the number of patients and improve the efficiency of medical op

关 键 词：超长住院日 影响因素 LOGISTIC回归模型 对策 

分 类 号：R197.3[医药卫生—卫生事业管理]