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中文摘要: 目的：分析煤矿地区某三甲医院整改前后的患者住院时间大于30天原因，探讨适宜的应对方案，为今后医院合理分配和提高医疗资源的使用效率提供参考。方法：选取某三甲医院在2018-2019年期间住院天数超过30天的5 059例患者作为研究对象，通过系统回顾分析病例住院资料，包括患者一般情况、疾病类型、住院天数、医疗付费方式及长时间住院原因等，对比分析整改前后的变化情况。结果：2018年住院时间超30天的患者占同期出院患者总数的6.01%（2019年为5.21%），占床天数为同期总数的20.15%（2019年为18.46%），平均住院天数为58.5（2019年为57.3）。这类患者中，男性以40~60岁年龄组所占比例较高，而女性年龄以30岁以下年龄组最多，性别构成在不同年龄组间均有统计学差异（P＜0.05）；住院费用支付方式上，比例最高为城镇医保（2018年为40.69%，2019年为45.16%），其次为个人支付（2018年为42.95%，2019年为27.98%），不同年份的支付方式构成有统计学差异（P＜0.05）；患者科室分布上，比例最高的为职业病科（2018年为37.41%，2019年为34.79%）。结论：煤矿地区医疗定点医院中职业病患者是住院时间超30天的最大群体，医院通过对此类疾病和收治科室进行重点管理，严控治疗各个环节和有效提高医疗资源使用效率，初步改善了患者住院时间偏长的问题，但后续仍需积极总结经验，以进一步提高医院的管理水平和医疗质量。
Abstract:Objective：To analyze the reasons why patients were hospitalized for more than 30 days in a certain Grade-A Tertiary Hospital in coal mine area and propose solutions to improve the efficiency of medical resources.Provide a reference for the hospital to rationally allocate and improve the use efficiency of medical resources in the future. Methods：The clinical data of 5,059 patients with more than 30 days of hospitalization in a certain Grade-A Tertiary Hospital from January 2018 to December 2019 were retrospectively analyzed which including general condition，disease type，length of hospitalization，medical payment method and reasons for long hospitalization，were analyzed to compare the changes before and after the rectification. Results：The patients who were hospitalized for more than 30 days accounted for 6.01% of the total number of discharged patients in 2018（5.21%in 2019）. The number of bed days occupied by patients with hospitalization longer than 30 days accounted for 20.15% of the total number of bed days of patients discharged from hospital in 2018（18.46%in2019），and the average length of hospitalization was 58.5（57.3 in 2019）；patients aged around 40~60 years accounted for the highest proportion among male，and patients aged below 30 years accounted for the highest proportion among female.There was a statistical difference in the gender composition in different ages（P < 0.05）.The highest proportion of expense payment mode was urban medical insurance（40.69% in 2018，45.16% in 2019）and individual payment（42.95% in 2018，27.98% in 2019）. There was a statistical difference in the composition of payment method in different years（P < 0.05）.The occupational diseases department has the highest incidence of coal silicosis（37.41% in 2018，34.79% in 2019）. Conclusion：In coal mining area medical fixed-point hospital，the occupational disease patients are the largest group who stay in hospital for more than 30 days. By managing such diseases and the key admission departments，controlling all aspects of treatment strictly and effectively improving the service efficiency of medical resources，the hospital has initially improved the problem of long hospitalization time of patients. However，we still need to summarize the experience actively in order to improve the management level and medical quality of the hospital.
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基金项目:安徽省人文社会科学研究项目（项目编号：SK2018A0168） 安徽省人文社会科学研究项目（项目编号：SK2018A0168）
引用文本：
陈 璇,胡继兵*,徐王权.煤矿地区某三甲医院患者住院时间超30天原因回顾性分析△[J].江苏卫生事业管理,2020,31(6):788-792.
Chen Xuan,Hu Jibing*,Xu Wangquan.Retrospective analysis on the reasons of staying in a certain Grade-A Tertiary Hospital in coal mine area for more than 30 days△[J].Jiangsu Health System Management,2020,31(6):788-792.
陈 璇,胡继兵*,徐王权.煤矿地区某三甲医院患者住院时间超30天原因回顾性分析△[J].江苏卫生事业管理,2020,31(6):788-792.
Chen Xuan,Hu Jibing*,Xu Wangquan.Retrospective analysis on the reasons of staying in a certain Grade-A Tertiary Hospital in coal mine area for more than 30 days△[J].Jiangsu Health System Management,2020,31(6):788-792.
