摘要
目的 探索某院 31天内再入院主要影响因素,为提升医院科学管理及医疗服务水平提供参考依据.方法 以某院 2017年1 月 1 日-2021 年 12月 31日的 205 518人次住院病案为统计资料,利用SAS 9.4统计软件编程,从中检索出入院次数≥2 次,两次出入院时间差≤31 天的病案 60 552份,对导入SAS数据集的相关信息通过入院时间差为一周、两周、三周、一个月以及年龄、科室、疾病分类等方面对再入院病案数据进行整理分析.结果 某院 2017 年-2021年患者 31 天内再入院率在 2020 年和2021 年时有所降低,但5年平均31天内再入院率仍然高达29.46%;再入院类别以当日再入院(35.34%)和一月再入院(43.33%)为主;再入院患者年龄集中在 40 岁～69 岁,占比 57.77%;ICD-10 分类中Z51(肿瘤放化疗、靶向及支持治疗)占比 49.9%、L90(烧伤后的皮肤瘢痕)占比 7.66%、I63 占比 2.39%、J98(呼吸系统感染及气管、支气管狭窄)占比 2.25%.结论 某院 31 天内再入院率偏高,当日再入院情况比较突出.应根据科室特点及疾病分布完善再入院患者监控管理体系,协同科室找准学科定位发展,杜绝人为方式美化指标.
Abstract
Objectives To explore the main influencing factors of readmission within 31 days in a hospital,and provide reference for improving the scientific management and medical service level of the hospital.Methods Using 205,518 inpatient records of a hospital from January 1st,2017 to December 31st,2021 as statistical data,using SAS 9.4 statistical software programming,we retrieved 60552 medical records with≥2 admissions and≤31 days difference between the two admissions.The relevant information imported into SAS data set was sorted out and analyzed by the hospitalization time difference of one week,two weeks,three weeks,one month,age,department,disease classification and other aspects.Results The 31-day readmission rate of patients from 2017 to 2021 decreased in 2020 and 2021,but the 5-year average 31-day readmission rate was still as high as 29.46%.The main types of readmission were intra-day readmission(35.34%)and intra-month readmission(43.33%).The age of readmitted patients was concentrated in 40-69 years old,accounting for 57.77%.In the ICD-10,Z51(tumor radio-chemotherapy,targeted and supportive treatment)accounted for 49.9%,L90(skin scar after burn)accounted for 7.66%,I63 accounted for 2.39%,and J98(respiratory system infection and trachea and bronchial stenosis)accounted for 2.25%.Conclusions The readmission rate within 31 days was higher in one hospital,and the readmission rate on the same day was more prominent.We should improve the monitoring and management system of re-hospitalized patients according to the characteristics of the department and the distribution of the disease,and cooperate with the department to identify the positioning and development of the discipline,and avoid the artificial way to beautify the indicators.
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万方数据