中国医院
中國醫院
중국의원
CHINESE HOSPITALS
2013年
3期
17-18
,共2页
临床路径%住院费用
臨床路徑%住院費用
림상로경%주원비용
clinical pathway%Hospital expense
目的:探讨临床路径住院费用的关键影响因素,为制定有效控制住院费用的方案提供参考依据.方法:查阅文献后选择待分析的18项影响因素,抽取2011年4月至10月实施临床路径的214例患者病历,收集并记录来自于医院内部、患者自身、疾病转归三大方面18项影响指标的具体情况,进行多因素Logistic回归分析后确定影响临床路径住院费用的关键指标.结果:经二分类变量的Logistic回归分析,抗生素使用不合理(P=0.000,OR=6.615)、检查超出规定范围(P=0.027,OR=3.585)、患者拒绝出院(P=0.003,OR=5.218),发生并发症(P=0.004,OR=6.171)、药占比高(P=0.034,OR=3.486)、合并基础疾病(P=0.004,OR=8.106)共6个因素最终进入回归模型方程.结论:临床路径住院费用受到多因素影响,抗生素使用不合理、检查超出规定范围、患者拒绝出院、发生并发症、药占比高、合并基础疾病可能是影响临床路径卫生经济学指标的关键因素.
目的:探討臨床路徑住院費用的關鍵影響因素,為製定有效控製住院費用的方案提供參攷依據.方法:查閱文獻後選擇待分析的18項影響因素,抽取2011年4月至10月實施臨床路徑的214例患者病歷,收集併記錄來自于醫院內部、患者自身、疾病轉歸三大方麵18項影響指標的具體情況,進行多因素Logistic迴歸分析後確定影響臨床路徑住院費用的關鍵指標.結果:經二分類變量的Logistic迴歸分析,抗生素使用不閤理(P=0.000,OR=6.615)、檢查超齣規定範圍(P=0.027,OR=3.585)、患者拒絕齣院(P=0.003,OR=5.218),髮生併髮癥(P=0.004,OR=6.171)、藥佔比高(P=0.034,OR=3.486)、閤併基礎疾病(P=0.004,OR=8.106)共6箇因素最終進入迴歸模型方程.結論:臨床路徑住院費用受到多因素影響,抗生素使用不閤理、檢查超齣規定範圍、患者拒絕齣院、髮生併髮癥、藥佔比高、閤併基礎疾病可能是影響臨床路徑衛生經濟學指標的關鍵因素.
목적:탐토림상로경주원비용적관건영향인소,위제정유효공제주원비용적방안제공삼고의거.방법:사열문헌후선택대분석적18항영향인소,추취2011년4월지10월실시림상로경적214례환자병력,수집병기록래자우의원내부、환자자신、질병전귀삼대방면18항영향지표적구체정황,진행다인소Logistic회귀분석후학정영향림상로경주원비용적관건지표.결과:경이분류변량적Logistic회귀분석,항생소사용불합리(P=0.000,OR=6.615)、검사초출규정범위(P=0.027,OR=3.585)、환자거절출원(P=0.003,OR=5.218),발생병발증(P=0.004,OR=6.171)、약점비고(P=0.034,OR=3.486)、합병기출질병(P=0.004,OR=8.106)공6개인소최종진입회귀모형방정.결론:림상로경주원비용수도다인소영향,항생소사용불합리、검사초출규정범위、환자거절출원、발생병발증、약점비고、합병기출질병가능시영향림상로경위생경제학지표적관건인소.
Objectives:To explore the key factors that affect hospital expense of clinical pathway and to provide references for the effective control hospital expense. Methods:Based on literature review, 18 factors were selected. 214 cases of patients’ records who was brought into clinical pathways management from April to October 2011were selected and the 18 indicators in three aspects of hospital, patient and disease prognosis were collected. Multivariate logistic regression analysis was used to determine the key indicators influencing hospital expense of clinical pathway. Results: According to binary variable Logistic regression analysis, irrational use of antibiotics(P=0.000,OR= 6.615), examinations out of range(P=0.027,OR=3.585), patients refused to discharge(P=0.003,OR=5.218), complications(P=0.004,OR=6.171), high drug proportion(P=0.034,OR=3.486), within underlying diseases(P=0.004,OR=8.106)eventually entered into the regression model equation. Conclusions: Multiple factors affect hospital expense of clinical pathway, irrational use of antibiotics, examinations out of range, patients refused to discharge, complications, high drug proportion, within underlying diseases may be the key indicators of the health economics in clinical pathway.
