新疆某三甲医院肿瘤日间病房运行效果

目的 探索日间病房的运行管理模式,对日间病房运行中存在的问题提出解决建议,以提高社会医疗资源的有效利用,减轻患者经济负担.方法 收集新疆某三甲医院2015年1月-2016年4月肿瘤中心普通病房病例5 669例与日间病房病例1 141例,采用回顾性队列研究的方法,从医保支付方式、平均住院日、出院转归情况、患者经济负担、31天再入院计划及收治患者类型等6个方面进行对比.结果 相比普通病房,日间病房区级医保占比提高4.18％、平均住院天数缩短5.17天、平均费用减少6914元、31天无再住院计划的患者占比提高14.25％.普通病房收治患者人数最多的三个病种分别为肠恶性肿瘤术后化疗患者、肺部恶性肿瘤化疗患者、胃恶性肿瘤术后化疗;日间病房收治患者人数最多的三个病种分别为甲状腺恶性肿瘤手术后随诊检查、肠恶性肿瘤化学治疗后随诊检查、恶性肿瘤联合治疗后随诊检查.普通病房主要收治化疗患者,占42.99％;日间病房主要收治随访检查患者,占比73.18％.结论 日间病房在调整医保付费方式,缩短平均住院日,降低患者经济负担,加速康复,为随访检查患者提供便利等方面有着重要的作用,可能会成为一种新型有效的医疗模式.

Analysis of the Operation Effect of Day-care Cancer Ward in a Tertiary Hospital in Xinjiang

Objective This paper explores the operation and management pattern of the day-care ward and puts forward solutions to problems in running the day-care ward, so as to promote effective utilization of social medical resources and relieve economic burden of patients.Methods A total of 5669 cases of general wards and 1141 cases of day-care wards were collected from a tertiary hospital in Xinjiang between January 2015 and April 2016.Retrospective cohort study method was applied to make contrast in six aspects: medical insurance payment, average length of stay, outcome of discharge, economic burden, no re-hospitalization plan after 31 days, and type of the admitted patients.Results Compared with general wards, the proportion of district healthcare of the day-care unit increased by 4.18％, average length of stay was reduced by 5.17 days, average cost was reduced by 6914 yuan, and proportion of no re-hospitalization plan after 31 days increased by 14.25％.The top three diseases for which patients are admitted to general wards are chemotherapy after intestinal malignant neoplasm, chemotherapy after pulmonary malignant tumor, and chemotherapy after gastric malignant tumor.The top three diseases for which patients are admitted to day-care wards are follow-up examination after thyroid malignant tumor surgery, follow-up examination after intestinal malignant tumor chemotherapy and follow-up examination after malignant combined therapy.General wards mainly treat chemotherapy patients, accounting for 42.99％;day-care wards mainly treat patients of follow-up examination, accounting for 73.18％.Conclusion Day-care ward plays an important role in adjusting the medical insurance payment method, reducing the average length of hospitalization, reducing patients' economic burden, accelerating rehabilitation, providing convenience for follow-up examination patients, and thus may hopefully become an efficient medical model.