Analysis of Distribution Characteristics and Influencing Factors of 1869 Patients with Prolonged Hospitalization Days
Objectives This study aims to analyze the distribution characteristics and influencing factors of over-stayed patients in a tertiary general hospital and explore measures to shorten the average length of stay.Methods The front-page information of all discharged patients from January 1,2020 to December 31,2022 was collected.The 99th percentile of discharged patients'length of stay(P99=48 days)was defined as prolonged hospitalization days.Multi-factor unconditional logistic stepwise regression was used to analyze the prolonged hospitalization days based on patient gender,age,patient source,payment method,number of hospitalizations,hospitalization departments,admission methods,discharge methods,case classification,disease classification,surgical conditions and other characteristics.Results A total of 1,869 inpatients were hospitalized for more than 48 days,accounting for 1.00％of the total number of discharged patients.The male to female ratio was 1.49∶1,and the average hospitalization day was 8 1.57 days.The top five diseases of patients with prolonged hospitalization days were injury,poisoning and some other consequences of external causes(37.13％),circulatory system diseases(19.74％),factors affecting health status and exposure to health care institutions(12.95％),respiratory systemic diseases(7.92％),and tumors(6.15％).The top five departments were neurosurgery,orthopedics,oncology,rehabilitation and burns,and plastic surgery and wound repair.The results of multi-factor unconditional logistic stepwise regression showed that the risk factors with greater influence were injury,poisoning and some consequences of external causes(OR=6.344),transfer to another department(OR=5.527),skin and subcutaneous tissue diseases(OR=5.036),non-clinical pathways(OR=4.880),and factors affecting health status and contact with health care institutions(OR=4.115).Conclusions The main factors affecting the prolonged hospital stay are postoperative complications of difficult and complex surgeries,severe sequelae of cerebrovascular disease,and multiple systemic complications caused by decreased human body function.Hospitals should strengthen the specialty construction of relevant departments and disease supervision and promote the diversification of multidisciplinary diagnosis and treatment models.High-level hospital diagnosis and treatment technology should continue to be effectively introduced,and technical flexible support improves the medical service level of client units.The perioperative care management system should be established and improved to effectively shorten the average length of stay for inpatients.
Patients with prolonged hospitalization daysDistribution characteristicsInfluencing factors
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