Analysis of cas with patients hospitalized for more than 30 days in 2014-2016 in a sanjia hospital in
suzhou
Abstract
Objective:The average residential day is a comprehensive indicator of hospital medical quality and management level. The longer hospital stay has adver effects on both the patients and the hospital. How to effectively shorten the average hospital day has become an important issue to be solved in hospital management. Therefore, this study firstly analyzed the cas of patients who were hospitalized for more than 30 days from 2014 to 2016 in a sanjia hospital in suzhou in order to find out the influence factors of the over-30 days in the hospital. Then, bad on the data of 2016, the relationship between influencing factors and factors was analyzed, and relevant measures and experience of shortening the residential day in China and abroad were analyzed, and the management of the patients in the hospital for over 30 days was mainly implemented to realize the rational allocation and utilization of the existing medical resources.
Method: Through the hospital information management system (HIS), the patient's medical records were derived, and the general situation of the patients, the source of hospital expens and the compo
sition, the infection and prognosis of the patients were collected, and the statistical analysis was carried out using Excel and SPSS software. Further analysis includes single factor and multifactor variance analysis, correlation analysis and grey correlation analysis, k-means clustering analysis and ID3 decision tree analysis,etc.
Results:
1. Ca analysis of patients hospitalized for more than 30 days in 2014 and 2016.
The number of hospitalized patients in the hospital incread year by year, but the proportion of patients admitted to the hospital over 30 days decread year by year. Over 30 days of hospitalization, most of the patients were male, age >60 and medical
insurance patients, and there was no difference in constituent ratio in the past three years. Top five ordinal for malignant tumor, respiratory system dias, circulatory system dia, digestive system dias and dias of the urogenital system.后臀尖>青山处处埋忠骨教案
2. In-depth analysis of data from patients hospitalized for more than 30 days in 2016.
To analyze the distribution of hospitalization day, age, number of operation, whether or not, whether t
ransferred to branch, different kinds of dias, and the basic statistic and distribution characteristics of hospitalization days, age, cost, and the composition of medical expens in patients hospitalized for more than 30 days in 2016. It was found that there are differences in the patients' attributes, the distribution of hospital day and the cost of the different dias, which provide the basis for the differentiated bed management of different departments.
The influencing factors of hospitalization over 30 days were analyzed by correlation analysis. Grey correlation analysis and stepwi regression analysis showed that age, dia type and hospitalization expens were the main influencing factors. In this paper, the ca of patients with long hospital stay was analyzed by means of k-mean cluster analysis, and the four groups were gathered together, and the characteristics of patients and expens of different clustering were analyzed.Finally, taking the over 30-day medical record of hospitalization as the training data, the decision tree model of the average hospitalization day and the hospitalization cost was established, the independent variables were the age, the verity, the dia type and the gender, and the future cas could be forecasted according to the related attributes.
Conclusion:
1. Attention needs to be paid to the health status of men and elderly groups. The method of payment objectively affects the length of hospital stay. Dia itlf is a major factor in length of stay in hospital.
2. Differentiated hospital bed management should be adopted in different departments.
3. Bad on the in-depth analysis of the data, and the domestic and international related measures and experience of the closing of the hospital, we have a way to make effective management of patients who have been hospitalized for over 30 days. Mainly:
the implementation of clinical pathway management, single dia management, hospitalization process optimization, expand outpatient, day surgery, improve medical technology, information and two-way referral.
Key words:Hospitalization over 30 days; Average hospital day; Influencing factor; Correlation analysis.
Written by: Guang-Yu Lan
味道什么Supervid by: Da-Bing Lu
目录
引言 (1)
植树秀第一部分苏州市某三甲医院2014-2016年住院超过30天患者病例分析 (4)
1资料与方法 (4)
猫的智商排名1.1 数据来源 (4)
1.2 分析方法 (4)
1.3 分析工具 (4)
2相关概念 (5)
2.1 平均住院日 (5)
2.2 临床路径 (5)
3结果 (5)
3.1 2014-2016年全院出院患者的总体情况 (5)
3.2 2014-2016年住院超30天患者的基本特征构成比的比较 (7)
3.3 2014-2016年住院超30天病人的病种变化 (7)
4讨论 (8)
4.1 关注男性和老年人群体的健康状况 (8)
4.2 支付方式客观上影响住院时间的长短 (8)
4.3 疾病本身是住院时间长的主要因素 (9)
花篮开业5建议 (9)
5.1 积极推进双向转诊机制 (9)
5.2 加强对参保患者的住院管理 (9)
5.3 重点病种重点监管 (9)
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5.4 加强考核 (9)
第二部分苏州市某三甲医院2016年住院超过30天患者影响因素及其相关性分析 (10)
1资料与方法 (10)
1.1 数据来源 (10)
1.2 分析方法 (10)
1.3 数据处理及统计方法 (11)
2影响因素及相关性分析 (11)
2.1 2016年全院出院患者的总体情况 (11)
2.2 住院超30天患者的住院日分布的影响因素 (13)
2.3 住院时间的影响因素分析 (23)
3讨论与建议 (46)
3.1 实施临床路径管理 (46)
3.2 单病种管理 (47)
3.3 住院流程优化 (47)
3.4 拓展门诊功能 (49)
3.5 日间手术 (49)
3.6 提高医疗技术水平 (50)
3.7 运用信息化技术 (50)
3.8 推行双向转诊 (51)
主要结论 (52)
参考文献 (53)
攻读学位期间公开发表的论文 (57)
致谢 (58)
