摘要
目的分析郑州市某三级甲等综合医院2017年超长住院日患者分布特征,为缩短平均住院日、提高医院与社会经济效益提供数据依据。方法从医院信息系统中提取住院日≥60 d的出院患者信息,采用Excel、SPSS 19. 0进行数据处理和分析。结果超长住院日患者达513人次,占出院人数的1. 07%;超长住院日患者使全院整体平均住院日延长了0. 80 d。调查对象中男性构成比明显高于女性,男性占66. 47%,女性占33. 53%;超长住院日患者主要分布在<5岁组和50～70岁年龄组,比例分别为48. 00%和19. 50%;前三位付费方式患者人数分别是城乡居民医保患者(占48. 15%)、全自费患者(占22. 42%)和城镇职工医保(占15. 79%);超长住院日患者出院科室排在前五位的为儿童康复医学科、神经外科、神经内科、骨科、放疗科;超长住院日患者的主要诊断前三位为脑性瘫痪(19. 49%)、童年孤独症(8. 38%)、智力低下(8. 19%)。结论上级卫生行政管理部门和医疗机构应加强医联体建设,疏通转诊渠道,积极开展临床路径,加快实施DRGs预定额付费制;医疗机构应加强对超长住院日患者的管理,建立预警机制,针对重点科室、重点病种多管齐下缩短平均住院日。
Objective: The distribution characteristics of patients with ultra-long inpatient days in 2017 in a comprehensive Hospital of Class A Grade Three in Zhengzhou were analyzed to provide data basis for shortening the average inpatient days and improving social and economic benefits of the hospital. Methods:Information of the discharged patients with a hospital stay of more than or equal to 60 days was extracted from hospital information system,and data processing and analysis were conducted using EXCEL and SPSS 19.0. Results:The number of patients with long inpatient days reached 513,accounting for 1.07% of the discharged patients.And the average length of stay was 0.80 d longer.The composition of male was significantly higher than that of female,with male accounting for 66.47%,and female for 33.53%.The patients were mainly distributed in the <5 years old group and the 50~70 years old group,with the proportion of 48.00% and 19.50% respectively.The number of patients with the first three modes of payment is medical insurance for urban and rural residents (48.15%),self-funded medical expenses (22.42%) and medical insurance for urban and rural employees (15.79%).Children’s rehabilitation medicine,neurosurgery,neurology,orthopedics and radiotherapy were the top five discharge departments with patients of long hospital stay.The top three diagnoses of the patients with long hospital stay were cerebral palsy (19.49%),childhood autism (8.38%),and mental retardation (8.19%). Conclusion:Therefore,superior health administrative departments and medical institutions should strengthen the construction of medical association,dredge the channels of referral,actively carry out clinical pathway,and accelerate the implementation of DRGs predetermined payment system.Medical institutions should also strengthen the management of patients with long hospital stay,establish an early warning mechanism,strengthen the supervision of key departments and key diseases,and shorten the average hospital stay with multiple measures.
作者
楚子君
刘海洋
刘艳
郜会杰
CHU Zi-jun;LIU Hai-yang;LIU Yan;GAO Hui-jie(Information and Tele-medical Section,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《现代医院管理》
2019年第2期21-23,27,共4页
Modern Hospital Management
关键词
平均住院日
超长住院日
DRGS
对策
average length of stay
long hospital stay
DRGs
countermeasure
