Studies On Inappropriate Hospitalization Days For Clinical Priority Diseases Of A Certain Hospital In Xinjiang

Objectives: In the retrospective study of inappropriate hospitalization days for6types of clinical priority diseases conducted at a certain third-level grade A hospital inXinjiang, the rationality of hospital days for each disease was evaluated, did analysis thecauses and influence factors of inappropriate hospital days and provided gist to reduce theinappropriate hospital days. Methods: The6types of clinical priority diseases in Xinjiangoccurred during2009-2013were taken as examples. Hypertension (I10), acute myocardialinfarction (I21), chronic obstructive lung disease (J44), benign prostatic hyperplasia (N40),traumatic brain injury (S06), acute appendicitis (K35) were listed as research objects.ICD-10category retrieval was conducted with medical records management software, and600medical records were selected by SYS sampling with a total of7,24,7hospital days;Appropriateness evaluation program (AEP) for hospitalization days were used to evaluatethe subjective and objective part of each medical record, while the delay reasons wereaggregated using the delay tool. During the evaluation process, all the data entry werecompleted with the EPIDATA2.0, and the statistical analysis of influencing factors weredone with the SPSS19.0.Results: Among the7,247hospitalization days of6types ofclinical priority diseases, of which940days were inappropriate hospitalization days,accounted for10.03%of the actual adjusted inappropriate hospitalization days (727).After the inappropriate hospitalization days were removed, the average hospitalizationdays for hypertension, acute myocardial infarction, chronic obstructive pulmonary disease,benign prostatic hyperplasia, traumatic brain injury and acute appendicitis can be reducedby1.30,1.09,1.58,1.19,0.30and1.52days, respectively; while the incomes can beincreased for2.37,1.50,1.24,0.54,0.42and0.10million Yuan, respectively;12influencing factors can be included in the regression model through the influencing factoranalysis, while the payment pathways, the patient’s age, the condition of an initially admitted patient, the operation level, the source of patients, the readmission plan in31days, the waiting days before operation were of statistically significance for inappropriatehospitalization days, of which the payment pathways affect the most.Conclusions:Though the inappropriate hospitalization days in this hospital is at lower level, but canalso be reduced through the optimization of part clinical medical laboratory workingprocesses. For the6type diseases, the hospitalization expense is positively associated withthe hospitalization days, which means that not only can shorten hospital stay can lightenthe economic burden of patients, but also can bring positive social benefits and economicbenefits.