日间手术模式下医疗费用及床位使用情况的研究

目的:观察仁济医院的日间手术管理模式对于医疗费用支出以及手术科室和全院床位使用情况的影响.方法:选择开展日间手术模式后手术科室患者3343例为研究组,以往同期非日间手术模式下手术科室患者2903例为对照组,观察2种模式下手术科室的单位床位手术例数、平均住院天数以及全院平均住院天数的变化差异.同时选择6种各科室有代表性的常见日间手术分组,与以往同期非日间手术模式下对照比较,观察2种模式下人均总费用、人均药费、药费比、平均住院天数的差异.结果:日间手术模式下手术科室的单位床位手术例数较非日间手术时期明显增加(P＜0.05),手术科室平均住院日明显下降(P＜0.01),且全院的平均住院日亦有明显的下降(P＜0.05).6组不同病种日间手术模式人均总费用、人均药费、药费比、平均住院天数大多较非日间模式显著下降.结论:日间手术能使单位床位手术例数提高,病床获得更充分的利用,不仅对于提高手术科室的床位使用率和周转率有重要作用,对于拉动全院床位使用有着积极的意义,而且可明显降低患者住院费用的支出,减少患者的药费支出,对医院收入的结构产生良性影响.

The Research on Hospitalization Expense and bed Utilization in DOMM

Objective: To observe the change caused by 'Daytime Operation Manage Mode(DOMM)' to the expense of medical treatment and the bed utilization of the surgery section as well as that of the hospital.Method: 3343 cases with 'DOMM' were investigated as the treatment group and 2903 cases in past corresponding period without 'DOMM' as the control group.The difference of operation amount per bed(s) unit,average hospitalization days was compared between two groups.In addition,6 familiar typical daytime operation groups were selected to compare with those without 'DOMM' in past corresponding period to observe the difference of total expense and drug expense per capita,drug expense rate,average hospitalization days.Result: In DOMM group,operation amount per bed(s) unit was increased statistically(P<0.05) and average hospitalization days of the operation section decreased significantly(P<0.01) as well as the average hospitalization days of the hospital(P<0.05).Total expense,drug expense per capita,drug expense rate,average hospitalization days of the 6 daytime operation groups were also decreased compared with the control group.Conclusion: DOMM can increase the operation amount per bed(s) unit and make the hospitalization more sufficient.It is significant for improving the bed utilization rate and turnover rate of the operation section and the bed occupancy.Moreover,it can evidently reduce the inpatients' expense of hospitalization and drugs and benefit the income structure of the hospital.