影响医院平均住院日的因素评价与分析

目的分析评价影响医院平均住院日的因素,为医院制定控制平均住院日的措施提供依据。方法抽取深圳3大医院2008年出院者36084人次病案记录,利用单变量回归和多元逐步回归方法,计算出不同因素与出院者住院天数的定量关系。结果平均住院日的长短与院内转科、抢救次数、患者年龄、病例分型、手术、确诊天数等因素有关,与付款方式、出院科室、病人来源、主要诊断转归、入院月份、患者性别、门诊与出院诊断符合等因素无关。结论医院要找出影响平均住院日的因素,有针对性地制定相关措施,理顺诊疗流程,才能有效缩短平均住院日。     

2006-2010年出院者平均住院日统计分析

目的 为医院制订有针对性地措施控制平均住院日提供参考依据.方法 利用住院病人疾病分类报表,对我院2006-2010年出院者平均住院日和主要疾病系统构成分析.结果 2006-2010年我院出院者平均住院日在9.0～9.4日,呈逐年下降趋势.结论 缩短出院者平均住院日能降低病人的医疗费用、提高医院的病床周转率,同时能提高医院的社会效益和经济效益.应有针对性地制订相关措施,理顺诊疗流程,缩短平均住院日.     

非胰岛素依赖型糖尿病平均住院日影响因素研究

收集了某医院2007年1231份非胰岛素依赖型糖尿病患者资料，利用Eviews 5．0中的OLS异方差一致估计，从患者人口统计因素、临床因素、季节因素、支付方式等方面对影响非胰岛素依赖型糖尿病患者住院日的因素进行分析。研究发现．对非胰岛素依赖型糖尿病患者住院日影响最大的是支付方式，其次为主诊断转归、出院科室、手术次数、有无并发症等等．而患者来源与入院情况对平均住院日无显著影响。     

万元以上出院者住院费用分布及影响因素研究

目的分析出院者万元以上住院费用分布及其影响因素,为医院制定住院费用措施提供决策依据.方法选择某三级医院2003年全年出院病人,分析住院费用超过万元患者的费用情况、住院日等,并利用多因素模型对其影响因素进行综合分析.主要结果万元以上患者平均住院费、住院日等显著高于万元以下患者.万元以上住院费用的影响因素为：性别、年龄、住院日、出院情况、入院病情、护理级别等.结论控制大额医疗费用,须从缩短住院日、防治慢性病等因素入手.     

缩短平均住院日的方法与效益

出院者平均住院日,简称平均住院日,是指在一定时期内平均每个出院者住院时占用的床日数。它是评价医院工作效率、医疗质量、管理水平和有效利用卫生资源情况的重要指标之一。由于忽视效率和医疗     

缩短平均住院日 向质量和效率要效益

出院者平均住院日,特别是治愈者平均住院日,是衡量医院医疗质量、技术水平、工作效率和卫生资源利用情况的综合性指标,是检验医院质量、效率、医德、技     

超长住院病人对出院者平均住院日的影响分析

平均住院日是一个评价医院效率和效益、医疗质量和技术水平的比较硬性的指标.缩短出院者平均住院日能降低病人的医疗费用,扩大医院收容量,提高医院的社会效益,所以一直是医院管理的目标之一.     

恶性肿瘤患者医院感染的管理

目的 开展恶性肿瘤患者医院感染的持续质量管理，降低其医院感染率。方法 对我院肿瘤科恶性肿瘤患得752人及相关工作人员等进行持续质量管理。结果 恶性肿瘤患者医院感染率由管理前的14．2％下降至9．6％，两者统计学差异有显著性（P＜0．05）；平均住院日下降了17．03d，平均医疗费用下降了4240．5元。结论 持续质量管理是降低恶性肿瘤患者医院感染率的先进管理办法。     

缩短平均住院日对医疗质量与效益的影响

目的观察缩短平均住院日对医疗质量、工作效率、病人费用、医院员工收入的影响。方法通过充分调研，找出影响平均住院日的主要因素（如检查预约、手术室肾缺和利用不充分等），周密实施并采取必要的激励机制。结果平均住院日缩短在1．7天（由11．4天降至9．7天）的同时，工作效率提高，门急诊人次和出院病人数增加，医疗质量指标改善，病人费用降低而满意度提高，医院和员工收入提高。结论缩短平均住院日可提高医疗质量和工作效率，在降低病人费用的前提下通过增加工作量来提高医院和员工收入。     

某院平均住院日的主要影响因素分析与对策

目的：探讨平均住院日的影响因素以及缩短平均住院日的方法,为医院管理提供科学的参考依据。方法以某院2012年、2013年的数据为基础,运用描述性统计浅析了病人自身、社会及医院等三方面对医院平均住院日的影响。结果分析得出2013年出院者平均住院日7.5天,比2012年7.0天延长0.5天。结论影响平均住院日的因素是多方面的,因此,缩短平均住院日应该从多方面入手,做到科学的管理方法与科学的医疗方法相结合。     

Factors affecting the increase in hospitalized medical care expenditure in Japan: analysis of national data in all 47 prefectures]

To clarify factors affecting the increase in annual expenditure for hospitalized medical care in Japan, the effects of the following four variables in all 47 prefectures were analyzed: (1) the hospitalized medical care expenditure per day per inpatient, (2) the number of admissions per population base, (3) average length of stay of patients in hospital per year and (4) the number of hospital beds per population base. The annual expenditure for hospitalized medical care per population base was correlated most significantly with the number of hospital beds per population base. The annual expenditure was also significantly correlated positively with the number of admissions per population base and average length of stay of patients in hospital per year, and inversely with the hospitalized medical care expenditure per day per inpatient. Hospitalized medical care expenditure per day per inpatient was inversely correlated with average length of stay of patients in hospital and the number of hospital bed per population base. Results from stepwise multiple regression analysis indicated that the number of hospital bed per population base and the hospitalized medical care expenditure per day per inpatient are the only two variables which have significant effects on the annual expenditure for hospitalized medical care per population base. The annual rate of increase for annual expenditure for hospitalized medical care per population base from 1980 to 1986 was 6.1%. Similarly, the rate of increase in the hospitalized medical care expenditure per day per inpatient was 3.5%; that of the number of admissions per population base was 3.1%.(ABSTRACT TRUNCATED AT 250 WORDS)     

Estimating mean hospital cost as a function of length of stay and patient characteristics

Statistical models have been used to assess the influence of clinical and demographic factors on hospital charge and length of stay (LOS). Hospital costs constitute a significant proportion of overall expenditure in health care. With escalating costs, knowing the correlates of LOS and in-hospital cost is important for decisions on allocating resources. However, hospital charge and LOS are correlated. We describe two regression models that permit estimation of mean charges as a function of patient hospital stay and adjust for the influence of patient characteristics and treatment procedures on LOS and charge. In the first model, the mean charge over a specified duration is a weighted average of the expected cumulative charge, with weighting determined by the distribution of LOS. The second model for LOS and charge explicitly accounts for their correlation and yields estimates of the average charge per average LOS. The methods are applied to assess mean charges and mean charge per day by cardiac procedure in a cohort of patients hospitalized for acute myocardial infarction, while adjusting for the impact of patient demographic and clinical factors on LOS and charge. For relatively short hospital stays, and when only total hospital charges are available, these models provide a flexible approach to estimating summary measures on resource use while controlling for the effects of covariates on LOS and charge.     

某三甲医院超长住院患者特征及影响因素分析

目的通过分析某三甲医院超长住院患者分布情况及影响因素,进一步研究影响超长住院时间的主要因素,并探讨解决方案,为加快病床的周转率,提供临床依据和方案。方法从医院病案系统收集2018年1月-2018年12月医院收治的30230例出院病历首页资料,进行多因素非条件logistic回归分析,观察主要的影响因素。结果神经外科超长住院日患者人数最高,占超长住院患者总数28.70%。在平均住院天数中,康复医学最高,为(97.98±12.43)天。神经外科次均费用较高,为(12.83±2.46)万元。相对住院次数较低组,次数较高组是较低组的1.263倍,不同类型科室、疾病类型、医保付费方式和术前天数都是影响超长住院日的主要因素。结论大型公立医院受科室、疾病类型、付费方式、术前天数、手术等外部因素影响超长住院,应引进科学管理机制,规范诊疗行为,加快诊断相关分组(diagnosis related groups,DRGs)付费的实施,同时建立预警机制。     

Severe illness and death among injecting drug users in Scotland: a case-control study

Between April and September 2000, 60 injecting drug users in Scotland died or were hospitalized with severe illness. Laboratory investigations suggested that Clostridium novyi and other bacteria were important aetiological agents. To determine associated environmental/behavioural factors a case-control study was undertaken with 19 'definite' and 32 'probable' cases in Glasgow, Scotland. For every deceased case (n=19), up to three proxy individuals were interviewed. Three controls were identified for each case. Multivariate logistic regression analyses compared (i) all cases and controls; (ii) definite cases and matched controls; (iii) probable cases and matched controls. In all three analyses injecting into muscle or skin and injecting most of the time with a filter used by someone else were the variables most strongly associated with illness. Comparing only muscle-injecting cases and controls, cases were significantly more likely to have injected larger amounts of heroin per average injection than were controls. The findings make an important epidemiological contribution to the understanding of the public health and clinical implications of the contamination of illicit drugs by histotoxic clostridia.     

医院住院病人成本影响因素的研究

目的：确定医院住院病人的影响因素,并对其进行定量测量。方法：采用SPSS、NOSA软件,用最小二乘法,建立医院床位、床位和出院病人人数的回归模式,对模型进行了对比分析,并对医院其他影响因素进行了相关分析,最后用岭回归方法建立了23个变量的医院成本定量的经济模型。结果：发现不只医院的规模对医院成本有影响,医院的利用对医院成本也有重要的作用。结论：指出提高病床周转次数,缩短医院住院病人平均住院日是降低医院住院病人成本的主要途径。     

病例组合指数法在医院住院成本分析中的应用

目的：探讨住院病人成本的影响因素，并对其进行定量测量。方法：近照国际疾病ICD－9分类编码，采用病例组合指数法医院产出组成进行测量；彩和STAT，SPSS软件用最小二乘法，龄回归方法分别建立人均住院成本的回归模型并进行比较；对人均住院成本影响因素做相关分析；采用岭回归方法建立了引入病例组合指数等6个变量的人均住院成本的多元回归计量模型，结果：由于引入病例组合指数，考虑到了医院产出组成对人均住院成本的影响，使该成本分析更趋于合理；采用岭回归方法建立的回归模型相对于最小二乘法建立的回归模型而言，改善了自变量间多元共线性的效应，降低了回归系数的标准误，回归模型结果更稳定。结果：定量地测量了病例组合指数因素对人均住院成本的影响。     

Ecological analysis of social risk factors for Rotavirus infections in Berlin, Germany, 2007¿2009

ABSTRACT: BACKGROUND: Socioeconomic factors are increasingly recognised as related to health inequalities in Germany and are also identified as important contributing factors for an increased risk of acquiring infections. The aim of the present study was to describe in an ecological analysis the impact of different social factors on the risk of acquiring infectious diseases in an urban setting. The specific outcome of interest was the distribution of Rotavirus infections, which are a leading cause of acute gastroenteritis among infants and also a burden in the elderly in Germany. The results may help to generate more specific hypothesis for infectious disease transmission. METHODS: We analysed the spatial distribution of hospitalized patients with Rotavirus infections in Berlin, Germany. The association between the small area incidence and different socio-demographic and economic variables was investigated in order to identify spatial relations and risk factors. Our spatial analysis included 447 neighbourhood areas of similar population size in the city of Berlin. We included all laboratory-confirmed cases of patients hospitalized due to Rotavirus infections and notified between 01/01/2007 and 31/12/2009. We excluded travel-associated and nosocomial infections. A spatial Bayesian Poisson regression model was used for the statistical analysis of incidences at neighbourhood level in relation to socio-demographic variables. RESULTS: Altogether, 2,370 patients fulfilled the case definition. The disease mapping indicates a number of urban quarters to be highly affected by the disease. In the multivariable spatial regression model, two risk factors were identified for infants (<4 year olds): Rotavirus incidence increased by 4.95 % for each additional percent of unemployed inhabitants in the neighbourhood (95 % credibility interval (CI): 3.10 %-6.74 %) and by 0.53 % for each additional percent of children attending day care in the neighbourhood (95 % CI: 0.00 %-1.06 %). We found no evidence for an association with the proportion of foreign residents, population density, the residential quality of accommodations and resident changes in the neighbourhood. CONCLUSIONS: Neighbourhoods with a high unemployment rate and high day care attendance rate appear to be particularly affected by Rotavirus in the population of Berlin. Public health promotion programs should be developed for the affected areas. Due to the ecological study-design, risk pathways on an individual patient level remain to be elucidated.     

用多元回归分析小儿手术麻醉期间潮气量影响因素

目的 确定小儿手术麻醉期间机械通气时潮气量的影响因素。方法 采用ＳＡＳ软件对资料进行残养差分析，共线诊断并利用原点迫近回归实现龄回归分析。结果 在残差图上，学生化残差大致落在│ｒ│≤２的水平带状区域内且无任何趋势。一般回归分析的标准误大多大于１．５；身高和体重的方差构成比分别为９０．８７％和５１．３９％，均超过了５０％；在龄迹图２中，当Ｋ＝０．３时，龄迹大体稳定，据此所拟合的龄回归方程的所有回归系     

煤矿区大气污染与儿童呼吸道疾病住院人数的时间序列分析

目的评价神木县大气污染与儿童呼吸道感染住院人数的关系。方法收集2009年11月至2012年10月间神木县的气象因素（气温、相对湿度）和环境因素：二氧化硫（SO,）、二氧化氮（NO：）和可吸入颗粒物（PM10）,以及16岁及以下儿童的住院资料。利用SAS9．3对气象、环境因素和住院人数资料进行描述性分析,并判断主要污染物。利用R3．0．1统计软件的建立Poisson回归的广义相加模型,引入大气污染物浓度及气象因素拟合线性模型,并考虑其滞后效应,评价主要大气污染物对儿童呼吸道感染住院的相对危险度。结果神木县的首要污染物为PM10,PM10与空气污染指数（API）的相关系数为0．917,P〈0．01。在控制了长期趋势、“星期几效应”、气象因素及其它污染物的影响后发现,首要大气污染物PM10浓度每上升10μg／m3时,每日呼吸道感染住院患儿的上呼吸道相对危险度（RR）及其95％可信区间（95％cx）为1．002（0．996～1．007）,t=0．589,P=0．556;下呼吸道为1．000（0．995～1．005）,t=-0．007,P=0．995。当日或滞后1～10日内PM10浓度变化均不能显著改变儿童上、下呼吸道感染的住院率。结论神木县首要污染物PM10浓度变化对儿童上、下呼吸道感染的住院情况无明显影响。