| 2013年-2017年全国三级公立医院神经重症医疗质量现状分析 |
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| 引用本文： | 张琳琳,马旭东何璇,高浩然谷鸿秋,王海波尹畅王彩云,杨昕,李子孝,,王拥军,,周建新,.2013年-2017年全国三级公立医院神经重症医疗质量现状分析[J].中国卫生质量管理,2020,0(6):033-36. |
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| 作者姓名： | 张琳琳 马旭东何璇 高浩然谷鸿秋 王海波尹畅王彩云 杨昕 李子孝 王拥军 周建新 |
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| 作者单位： | 首都医科大学附属北京天坛医院 |
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| 摘 要： | 目的了解我国三级公立医院神经重症住院患者医疗质量现状。方法采用病案首页主要诊断和其他诊断的疾病编码，提取医院质量监测系统中2013年1月1日-2017年12月31日诊断为神经系统疾病的神经重症患者信息。采用SPSS 21.0统计软件对相关指标数据进行分析。结果全国506家三级公立医院共计220 027例神经重症患者纳入研究，其中，男性患者居多，占住院总人次的58.61%，年龄中位数（四分位数）为58（27，72）岁。患者住院死亡率和平均住院天数呈逐年下降趋势，出院人数逐年增加，机械通气时间逐年缩短，31天重返ICU率在小范围内波动。神经重症患者付费方式以城镇职工基本医疗保险为主，新型农村合作医疗保险次之。结论我国神经重症医疗质量逐年上升，救治水平在逐步提高，未来仍需继续关注结构、过程、结局指标，以持续改进。
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| 关 键 词： | 三级公立医院 神经重症 医疗质量 病案首页 质量改进 |
Analysis of the Status Quo of the Quality of Neurocritical Care Medicine in Chinese Tertiary Public Hospitals from 2013 to 2017 |
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| ZHANG Linlin,MA Xudong,HE Xuan,et al.Analysis of the Status Quo of the Quality of Neurocritical Care Medicine in Chinese Tertiary Public Hospitals from 2013 to 2017[J].Chinese Health Quality Management,2020,0(6):033-36. |
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| Authors: | ZHANG Linlin MA Xudong HE Xuan |
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| Affiliation: | Beijing Tiantan Hospital, Capital Medical University |
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| Abstract: | ObjectiveTo investigate the current status of the medical quality of neurocritical inpatients in tertiary public hospitals in China.MethodsBased on the disease code of the main diagnosis and other diagnoses on the first page of the medical record, data was extracted from patients who were admitted to the intensive care units during hospitalization due to neurological diseases from January 1, 2013 to December 31, 2017 in the hospital quality monitoring system (HQMS). The SPSS 21.0 statistical software was used for data analysis.ResultsAmong the 506 tertiary public hospitals, 220 027 patients with severe neurological diseases were included in the study. Among them, the majority of male patients accounted for 58.61% of the total hospitalization, and the median age and quartile were 58 (27-72) years old. The in-hospital mortality and average length of stay showed a downward trend, and the number of discharged patients increased year by year, the mechanical ventilation time shortened year by year, and the rate of 31-day return to ICU fluctuated within a small range. The basic medical insurance for urban workers was the main payment method for patients with severe neurological diseases, followed by the new rural cooperative medical insurance.Conclusion The medical quality of neurologic severe diseases in China was increasing year by year, and the treatment level was gradually improving. In the future, it still need to continue to pay attention to the structure, process and outcome indicators, and make continuous improvement. |
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| Keywords: | Tertiary Public Hospital Neurocritical Care Medical Quality Home Page of Medical Record Quality Improvement |
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