The Analysis Of Influencing Factors And Intervention Measures Study On Average Length Of Stay

Purpose:To know the general condition of length of stay for special diseases, analyze the influencing factors of ALOS. Combine with the specific management which focuses on ALOS control, to explore and discuss the effective intervention measures. Supply actural examples reference and advises.Methods:1) Five representative diseases were selected to study the influencing factors and internvetion measures for ALOS.2) Electric medical cases data from Jul to Dec 2009 and Jul to Dec 2010 through ODS resource for hospital statistics were obtained.3) The influencing factors by using cases data from Jul to Dec 2009 were studied, including disitribution and main statistic indexes value description, length of stays'difference description of cases grouped by varies dimensions by ANOVA, length of stay's influenceing factors analysis by multiple linear regression.4) Combined the result of influencing factor study, we selected the interventions of shortening preoperative hospital stay, shortening waiting time for first lab test, control extraordinary length of stay from hospital intervention management activities which focused on ALOS control, analysised and discussed the ALOS intervention results by comparison of cases data from Jul to Dec 2009 and from Jul to Dec 2010.Results:1) Cases data obtaining result:obtained 1072 primary hepatocellular carcinoma cases (336 from Jul to Dec 2009,736 from Jul to Dec 2010),664 typeⅡdiabetes(327 from Jul to Dec 2009,337 from Jul to Dec 2010),632Ⅲdegree of hypertension (265 from Jul to Dec 2009,367 from Jul to Dec 2010),2089 unstable angina (975 from Jul to Dec 2009,1114 from Jul to Dec 2010),645 lumbar disc herniation(308 from Jul to Dec 2009,337 from Jul to Dec 2010). 2) Influncing factor analyze result:①For rimary hepatocellular carcinoma cases with operations, preoperative hospital stay, patient class are influencing factors of length of stay, for cases without operation, charge type is influencing factor.②For typeⅡdiabetes cases, age, sex, charge type are influencing factors of length of stay.③ForⅢdegree of hypertension cases, age, waiting time for first lab test, patient class, charge type are influencing factors of length of stay.④For unstable angina cases with operations, preoperative hospital stay, age, patient class, charge type are influencing factors, for cases without operation, age, patient class, charge type are influnceing factors.⑤For lumbar disc herniation cases with operations, preoperative hospital stay, age are influnceing factors, for cases without operation, waiting time for first lab test and charge type are influnceing factors.3) Under the implement of hospital intervention management activities, preoperative hospital stay, waiting time for first lab test were effectively shorten, cases of extraordinary length of stay were decreased. Analyzed the cases of primary hepatocellular carcinoma, typeⅡdiabetes,Ⅲdegree of hypertension, unstable angina, lumbar disc herniation between Jul to Dec 200 and Jul to Dec 2010, the cases of typeⅡdiabetes,Ⅲdegree of hypertension, unstable angina were significantly shorten.Discussion:1) ALOS is a consequential index which can reflex the comprehensive level of hospital management. It's also a management starting point to control medical cost, increase medical economic benefit, enhance medical efficiency, and improve medical service quality. The study on the influencing factors and intervention measures for ALOS, can supply clue and measures for the improvement of clinic working flow, hospital human resource arrangement, medical resource utility, medical service efficiency and quality.2) Through the length of stay influncing factors study for cases data of 5 diseases, charge type is an important demographic influnceing factor for length of stay. Preoperative hospital stay and waiting time for first lab test are inportant controllable medical inlunceing factors. 3) To control the ALOS, we need the cooperation between administration and function departments, operation departments and wards, clinic and examination, lab departments, outpatient and inpatient departments.