住院适宜性评价模型在神经内科住院患者中的应用  

Application of Hospitalization Suitability Evaluation Model in Neurology Inpatients

作　　者：王馨艺 郭静[1] 李萍[1] WANG Xinyi;GUO Jing;LI Ping(The Second Affiliated Hospital of Xinjiang Medical University,Urumqi,830062,China)

机构地区：[1]新疆医科大学第二附属医院,新疆乌鲁木齐830062

出　　处：《中国社会医学杂志》2025年第2期226-231,共6页Chinese Journal of Social Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(XJDX1711-2223)。

摘　　要：目的分析神经内科住院患者住院日适宜性,了解不适宜住院日影响因素,为住院日管理提供借鉴。方法采用住院适宜性模型,从卫生服务、生命维持/照护、患者情况3个维度,对某三级综合医院神经内科2022年1-12月出院患者的6155个住院日的适宜性与不适宜性进行评价,并使用延迟分析工具解释不适宜住院日原因。采用多元线性回归模型分析导致不适宜住院日原因的影响因素。结果研究样本适宜住院日4512天,占73.32%,不适宜住院日1643天,占26.68%,341名(68.26%)住院患者存在不适宜住院日。73.50%的不适宜住院日为医院内部因素所致,26.50%为医院外部原因导致,诊疗前期的不适宜住院日低于中、后期。主要诊断、药物治疗、疾病相关诊断分组(DRG)组别、家庭关系、入院病情、医疗付费方式6类因素是不适宜住院日的危险因素。结论神经内科不适宜住院日多发生于住院中、后期,发生原因与诊疗流程等院方因素及非必要入院等患方因素有关;可通过将DRG作为管理抓手,规范入院行为、强化住院审核,提升适宜住院日占比。Objective By analyzing the suitability of hospitalization days for inpatients in neurology,we aim to understand the influencing factors of inappropriate hospitalization days and provide reference for hospitalization day management.Methods Using an inpatient suitability model,this study evaluated the suitability and unsuitability of 6155 hospitalization days for patients discharged from the neurology department of a tertiary comprehensive hospital from January to December 2022 from three dimensions:health services,life support/care,and patient condition.Delay analysis tools were used to explain the reasons for unsuitable hospitalization days.The multiple linear regression model was used to analyze the influencing factors of unsuitable hospitalization days.Results The study sample had a suitable hospital stay of 4512 days,accounting for 73.32%,and an unsuitable hospital stay of 1643 days,accounting for 26.68%.A total of 341(68.26%)hospitalized patients had an unsuitable hospital stay.73.50%of unsuitable hospitalization days were caused by internal factors in the hospital,26.50%were caused by external factors in the hospital,and the unsuitable hospitalization days in the early stage of diagnosis and treatment were lower than those in the middle and late stages.Six types of factors,including diagnosis,medication treatment,number of diagnostic related disease groups,family relationship,admission condition,and medical payment method were risk factors for unsuitable hospitalization days.Conclusion Inappropriate hospitalization days in neurology often occur in the middle and late stages of hospitalization,and the causes are related to internal hospital factors such as diagnosis and treatment processes,as well as patient factors such as unnecessary admission.DRG can be used as a management tool to standardize admission behavior and strengthen hospitalization review to increase the proportion of suitable hospitalization days.

关 键 词：神经内科 住院患者 住院日适宜性 适宜性评价方案 

分 类 号：R741[医药卫生—神经病学与精神病学]