临床重点疾病的不适当住院日研究

目的对新疆某三级甲等医院重点疾病的住院天数进行回顾性研究，发现诊疗流程中存在的不适当住院日，预测平均住院日的缩短空间。方法依照三级综合医院评审标准及实施细则，在重点疾病监测指标中选择某院2010—2012年3个内科疾病：高血压、急性心肌梗死、慢性阻塞性肺病：两个外科疾病：前列腺增生、颅脑损伤共200份病案资料的2496个住院日进行回顾性研究，并对可能影响的变量进行回归分析。结果2496个住院日中不适当住院日共217天，占到了8．7％，引起不适当住院日的三大主要因素分别是等待检查报告、出院不及时和等待手术，共产生177个不适当住院日，占到了不适当住院总天数的81．6％。结论高血压、急性心肌梗死、慢性阻塞性肺病、前列腺增生、颅脑损伤的平均住院日可以进一步缩短，其缩短幅度分别是1．3天、0．7天、1．0天、1．3天和1．1天。

Inappropriate HosPitalization Research of Clinical Priority Diseases

Objective To do retrospective study on hospitalization disease focus in a first class hospital in Xinjiang, to find the treatment process of inappropriate hospitalization days, and to shorten average hospitalization days. Methods According to the three level general hospital accreditation standards and rules, three internal medicine diseases in a hospi- tal from 2010 to 2012 were selected, including hypertension, acute myocardial infarction, chronic obstructive pulmonary disease; Two surgical diseases were selected, including benign prostatic hyperplasia and brain injury. A total of 2 496 hospitalization days of 200 medical records data were studied retrospectively, and the outcome variable regression was analyzed. Results Among 2 496 hospitalization days, inappropriate hospitalization days are 217 days, accounting for 8.7%, three factors of inappropriate hospitalization days in a hospital are as follows： waiting inspection report, not timely leaving hospital and waiting time for surgery. These produce a total of 177 inappropriate hospitalization days, accounting for 81.6% inappropriate hospitalization days of the total number of days. Conclusion Hypertension, acute myocardial infarction, chronic obstructive pulmonary disease, benign prostatic hyperplasia and traumatic brain injury can further shorten the average length of stay. The shortening amplitudes are 1.3 days, 0.7 days, 1.0 days, 1.3 days and 1.1 days respectively.