平均住院日影响因素实证分析

目的：研究平均住院日的影响因素及作用强度,为中国医院合理利用医疗资源提供参考依据。方法：以2003年北京市6所三甲医院的100 259个住院病人的病案首页数据为研究对象,结合Anderson模型,运用负二项回归对住院日的影响要素进行实证分析。结果：前定变量中除了婚姻状况外,其他前定变量、使能变量、需要变量对平均住院日都有显著性影响。敏感度分析结果显示了较好的稳健性。结论：医院在制定降低平均住院日策略时需要考虑前定变量、使能变量、需要变量这些因素的影响。

Empirical study on factors affecting inpatient length of stay

Objective To study the factors affecting inpatient expenses and the extent of affecting,and to provide references for approaches to medical cost control in China.Methods Length of stay was analyzed by studying the cover page of inpatient record of the 100,259 inpatients in six 3A hospitals in Beijing in 2003.Based on the Anderson Model,the Negative Binomial Regression was used to analyze the factors which affect the length of stay.Results Except for the marital status in the predetermined variables,the others need variables,predetermined variables and enabling variables significantly influenced the length of stay.Sensitivity analysis results revealed that the regression has a better stability.Conclusion The factors,including need variables,predetermined variables and enabling variables,significantly influence LOS.If LOS is used as a quality measure for hospitals and patients,adjustment for these factors is necessary.