某三级甲等医院超长住院日现状分析及对策

目的：通过分析超长住院日患者的相关影响因素，探讨缩短平均住院日的对策，为更好地开展医院管理提供参考依据。方法通过病案管理系统收集2012年10月—2014年10月住院日≥100天的患者资料，按照ICD-10进行疾病分类，通过 Visual FoxPro 6.0整理数据，应用 Excel 进行统计处理，对患者的年龄分布、性别构成、付费方式、住院费用、疾病构成进行分析。结果超长住院患者中，男性多于女性，男女比例为1.54??1；60岁以上病例数最多，共105例，所占构成比为33.55%；患者以全自费病人为主，占45.37%；排名前3位的疾病分别是损伤和中毒、循环系统疾病、肿瘤。结论医院应建立预警机制，提高精细化管理程度，优化就医流程，提高诊疗水平，有效降低平均住院日。

A Current Situation Analysis and Countermeasures of Long Hospitalization Days in a Tertiary Hospital

Objectives Through analyzing the influential factors of patients with long hospitalization days,to in-vestigate the countermeasure of shortening the average hospitalization days,to provide scientific basis for hospitals to carry out better management. Methods Materials of patients whose hospitalization days are longer than 100 days were collected from September 2012 to October 2014 according to medical record management system.Diagnosis is stratified by the ICD-10 disease classification.Data are sorted by Visual FoxPro 6.0 and processed statistical by Mi-crosoft Excel.Patient's age distribution,gender composition,payment method,hospitalization expenses,diseases com-position are analyzed.Results The proportion of male patients was larger than female patients,with the ratio of male to female of 1.54??1.The maximum age of patients was over 60-years and the total patients are 105 cases,account-ing for 33.55%.All self-pay patients ranked the first.The top three diseases were injury and poisoning,circulatory system disease,tumor.Conclusions Hospital should establish early warning mechanism,improve the degree of fine management,optimizing the treatment process,improve the level of diagnosis and treatment,and effectively reduce the average hospitalization days.