| 摘要: |
| 目的 运用住院日适当性评价方案（AEP）评价某三级甲等医院2009—2013年住院日适当性。方法 抽取2009—2013年间1—5月主要诊断为“肝硬化并伴有消化道静脉曲张出血”的患者病历，运用AEP进行回顾性分析，判断每一个住院日是否适当，并对不适当住院日进行原因和费用分析。结果 回顾472份病历，共计6 297个住院日。其中，942个住院日判断为无效，住院日不适当性比例为14.96%。性别、所在科室、是否节假日或周末、区域、付费方式、入院年份和其他诊断数目对住院日适当性的影响有统计学意义（P<0.05）。不适当住院日医疗费用共计77.5万元，若能有效控制，平均每患者住院费用可下降1 641.4元，平均住院日可下降1.996天。结论 与国内外相关研究相比，研究的不适当住院日比例处于中低等水平；院内采取综合管理措施，将有助于进一步改善住院日适当性。 |
| 关键词: 适当住院日评价方案 平均住院日 评估工具 病历 |
| DOI： |
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| 基金项目: |
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| Evaluation of the Hospitalization Appropriateness of a Third-Level Hospital in 5 years Based on AEP |
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| Abstract: |
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Objective
To estimate hospitalization appropriateness of a third-level hospital between 2009 and 2013 through AEP. Methods Medical records between January and May during 5 years(between 2009 and 2013) from a third-level hospital in Beijing were abstracted，of which the major diagnosis was Cirrhosis Complicated Hemorrhage Variceal Gastrointestinal Bleeding. A respective study was conducted with AEP to analyze whether a hospital length of stay was appropriate. The fee and causes of the inappropriate hospital day were also analyzed. Results 6 297 hospitalization days from 472 medical records were reviewed，of which 942 hospital stays were judged as inappropriate. The inappropriate hospitalization rate is 14.96%. The total cost for inappropriate hospitalization was 775 000 RMB，the mean inappropriate cost per patient was 1 641.4 RMB and the inappropriate length of stay per patient was 1.996 days. Conclusion The inappropriate hospitalization rate is in a middle-and–low level compared with the related records abroad. Better hospitalization appropriateness will be achieved if comprehensive measures are carried out within the hospital. |
| Key words: Appropriateness Evaluation Protocol,average length of stay,assessment tool,medical records |
