北京市某医院超长住院日患者影响因素分析  

Analysis of Influencing Factors of Patients with Prolonged Hospital Stay in a Certain Hospital in Beijing

作　　者：胡亚 高晓圆 郝松娟 肖三麦 Hu Ya;Gao Xiaoyuan;Hao Songjuan;Xiao Sanmai(Department of Hospitalization and Medical Record Management,Outpatient Department,Fourth Medical Center,PLA General Hospital,Bejing 100048,China;不详)

机构地区：[1]中国人民解放军总医院第四医学中心门诊部住院与病案管理科,北京市100048

出　　处：《中国病案》2024年第9期64-67,共4页Chinese Medical Record

摘　　要：目的探讨北京市某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。方法对某三级医院2022年1月1日-2022年12月31日期间1154例出院患者的超长住院日分布特征进行统计描述,运用Logistic回归模型分析其影响因素。结果超长住院日出院1154人次,占比3.29%,超长住院患者中平均年龄(58.69±8.79)岁,最小1岁,最大98岁。超长住院患者中神经外科、血液科占比最高,分别为16.48%和12.99%,前10位超长住院日科室累计构成比为77.03%。疾病分布中损伤、中毒和外因的某些其他后果和肌肉骨骼系统和结缔组织疾病占比最高,分别为24.09%和17.16%。回归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。同时通过标准化偏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,P<0.05,数据具有统计学意义。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 This study aims to explore the composition and influencing factors of hospitalization costs for patients with extended length of stay in a hospital in Beijing,in order to provide a reference for shortening the average length of stay and rational utilization of medical resources.Methods A statistical description was conducted on the distribution characteristics of ultra long hospital stay days among 1,154 discharged patients from a tertiary hospital from January 1 to December 31,2022.Logistic regression models were used to analyze the influencing factors.Results 1,154 patients were discharged due to prolonged hospital stay,accounting for 3.29%of the total.The average age of patients with prolonged hospital stay was 58.69±8.79 years old,ranging from 1 year old to 98years old.Among patients with long hospital stays,neurosurgery and hematology had the highest proportion,accounting for 16.48%and 12.99%respectively.The cumulative proportion of departments in the top 10 long hospital stays was 77.03%.In the distribution of diseases,injuries,poisoning,and certain other consequences of external factors,as well as musculoskeletal and connective tissue diseases,accounted for the highest proportions at 24.09%and 17.16%,respectively.Regression analysis showed that the factors that affect prolonged hospitalization ware in order of severity,age,gender,disease outcome,and surgical grade.At the same time,the standardized partial regression coefficient showed that critical illness had the greatest impact on excessive hospital stays and the data were statistically significant(P<0.05).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 operations.

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]