基于住院病案首页数据的老年慢性疾病患者超长时间住院影响因素研究  

Study on the influencing factors of long term hospitalization of elderly patients with chronic disease based on the homepage data of inpatient medical records

作　　者：周阳 杨敬源[1] ZHOU Yang;YANG Jingyuan(School of Public Health,Guizhou Medical University,Guizhou Province,Guiyang561113,China)

机构地区：[1]贵州医科大学公共卫生与健康学院,贵州贵阳561113

出　　处：《中国医药导报》2024年第25期76-80,共5页China Medical Herald

摘　　要：目的基于住院病案首页数据探究老年慢性疾病患者超长时间住院的影响因素。方法本研究选取2021年1月至2022年12月贵州省某三甲医院住院老年慢性疾病患者为研究对象。从医院信息系统调取病案信息,将住院日的95%分位数(16 d)作为超长时间住院的判定标准,将纳入患者划分为超长时间住院组和非超长时间住院组。比较两组的人口学因素(性别、年龄、婚姻状况)、疾病相关因素[有无手术及操作、入院途径、主诊断入院病情、是否转科、Charlson合并症指数(CCI)、老年营养风险指数(GNRI)]及医疗服务因素(是否30 d内再入院、医疗付费方式、有无出院31 d再住院计划)。多因素logistic分析老年慢性病患者超长时间住院的影响因素。结果研究共纳入6543例老年慢性病患者,住院日的95%分位数为16 d。超长时间住院患者329例,占总样本的5.03%。两组的年龄、有无手术及操作、入院途径、主诊断入院病情、是否转科、CCI、GNRI、是否30 d内再入院、有无出院31 d再住院计划等比较,差异有统计学意义(P<0.05);多重共线性诊断显示,方差膨胀因子均<5,不存在共线性。多因素logistic分析显示,年龄、有无手术及操作、主诊断入院病情、是否转科、CCI、GNRI等为超长时间住院的影响因素(P<0.05)。结论老年慢性疾病患者超长时间住院受到年龄、有无手术及操作、主诊断入院病情、是否转科、CCI、GNRI等多方面因素共同影响。Objective To explore the influencing factors of long term hospitalization in elderly patients with chronic diseases based on the data from the homepage data of hospitalization medical records.Methods Elderly patients with chronic diseases admitted to a tertiary hospital in Guizhou Province from January 2021 to December 2022 were selected as the research subjects.Retrieve medical recorded information from the hospital information system and used the 95%percentile of hospitalization days as the criterion for determining prolonged hospitalization.Patients were divided into the prolonged hospitalization group and the non prolonged hospitalization group.The demographic factors(gender,age,marital status),disease-related factors(presence or absence of surgery and procedures,admission route,primary diagnosis of admission condition,transfer of department,charlson comorbidity index,geriatric nutritional risk index),and medical service factors(whether readmission occurs within 30 days,medical payment method,and whether 31 days readmission plan after discharge)were compared between the two groups.Multivariate logistic analysis was used to investigate the influencing factors of prolonged hospitalization in elderly patients with chronic diseases.Results A total of 6543 elderly patients with chronic diseases were included in the study,with 95%percentile of 16 days of hospitalization.A total of 329 patients were hospitalized for an extended period of time,accounting for 5.03%of the total sample.There were statistically significant differences in age,presence or absence of surgery and procedures,admission route,primary diagnosis of admission condition,transfer of department,charlson comorbidity index,geriatric nutritional risk index,readmission within 30 days,and presence or absence of 31 days readmission plan between the two groups,the differences were statistically significant(P<0.05).The multicollinearity diagnosis showed that variance inflation factors were all less than five and there was no collinearity.Multivariate logisti

关 键 词：老年 慢性疾病 超长时间住院 影响因素 住院病案首页 回归分析 

分 类 号：R195.1[医药卫生—卫生统计学]