| Objective:To explore influence factors of the average length of stay(ALOS)in our orthopaedic surgery patients,and to discuss feasible measures of shorten the average length of stay of orthopaedic surgery patients.Methods:1)Refer to domestic literature of the average length of stay in surgical operation patients and orthopaedic surgery patients,and analysis possible influence factors of the average length of stay in orthopaedic surgery patients,combined those with our service positioning.Then learn effective measures of domestic and abroad hospital in shorten the average length of stay.2)Using retrospective study,collected all objects information based on our terminal medical management system among 2014.1-2016.12,the patients chosen from the first five cases of orthopaedic surgery patients strictly according to inclusion criteria and exclusion criteria.The database finally included 364 cases.Using one-way analysis of variance,groups were based on age,sex,occupation,trauma causes,medical insurance,case type,diseases,complication and year.3)Analysis of feasible measures of shorten the average length of stay.Results:1)Difference among age groups were statistically significant(P<0.05),with increasing of age,the average length of stay were longer in groups of 25≤,~35,~45,~55,however,groups of~65,>65 were shorter;2)Compared between groups of sex,the average length of stay between meal and female were significant difference(P<0.05),the average length of stay of male was longer than female;3)According to occupations,the average length of stay among groups had statistical difference(P<0.05),the average length of stay of worker was the longest,then farmer,retiree and other(include student,national public servant,management of company and technologist)were in sequence;4)Compared difference of trauma causes were statistical significant(P<0.05),The order of the average length of stay of patients were traffic accident injury,wounded/tools injury,bruise injury,knee osteoarthritis,fall/crush injury successively,traffic accident was the longest one,and fall/crush injury was the shortest one;5)Difference of the average length of stay among different medical insurance were statistical significant(P<0.05),patients with commercial insurance was the longest one,but the difference among medical insurance for urban workers,medical insurance for urban residents,new rural co-operative medical system and self-paying were no statistical(P>0.05);6)According to degree of severity,difference of the average length of stay among case types were statistical significant(P<0.05),the average length of stay of complicate and critical type was the longest one,pure urgent type,complicate and difficult type,ordinary type were successively;7)Compared difference of the average length of stay among five diseases were statistical significant(P<0.05),patients of tibia and fibula fracture had the longest the average length of stay,but difference among humerus fracture,femur intertrochanteric fractures,femoral neck fracture and knee osteoarthritis were no statistical(P>0.05);8)According to medical diagnosis,the average length of stay of patients with different complications were statistical significant(P>0.05),the average length of stay of multiple fractures combined tissue contusion patients,fracture patients merge with chronic diseases and emergency,single fracture combined tissue contusion patients were successively;9)Difference of the average length of stay among 2014,2015 and 2016 were no statistical(P>0.05);10)Pearson correlation analysis between the average length of stay and hospital costs showed positive correlation,r=0.679(P>0.05).Conclusions:1)The main influence factors of the average length of stay of the first five cases of orthopaedic surgery patients are personal factors,such as age,sex,trauma causes,diseases,case type,complication,and social factors,such as occupation,medical insurance.There are positive correlation between the average length of stay and hospital costs.2)Analysis of personal and social factors indicate that close cooperation among medical department,operation department and clinical department,integration of medical resources,introduction of new medical technology and new nursing pattern,improvement of medical service and treatment efficiency may shorten the average length of stay of orthopaedic surgery patients efficitively. |
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