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目的了解胃癌患者住院日的影响因素,为医院及卫生主管部门管理决策提供参考依据。方法收集山西省41所三级医院2014年一季度胃癌患者出院首页数据,利用多重线性回归统计学方法,回顾性分析胃癌患者住院日与患者性别、年龄、地区、付费方式、伴随诊断数量、手术、医院类型7因素的相关性。结果不同性别组、年龄组、付费方式组住院日比较无统计学意义(t=0.210,P=0.834;F=1.342,P=0.252;2χ=5.945,P=0.312),是否手术、医院类型、伴随诊断数量、不同地区(Mann-Whitney检验)组住院日比较有统计学意义(2χ=52.489,P<0.001;2χ=32.924,P<0.001;t=-21.026,P<0.001;Z=-8.149,P<0.001)。结论医院加强手术患者的管理、严格把握手术适应症、优化手术患者诊疗流程设计与管理、开展与基层医院双向转诊服务等对降低患者住院日水平有帮助;同时,卫生主管部门应引导患者理性选择就医地点,不盲目追求名医名院,避免出现少数医院患者过度集中现象,这不仅可有效缓解患者看病难看病贵,而且对缩短患者住院日也有实际意义。
Objective To understand the influencing factors of hospitalization days for patients with gastric cancer and provide references for the management decision of hospitals and health authorities. Methods The data of discharge from patients with gastric cancer in 41 hospitals of Shanxi Province in the first quarter of 2014 were collected. Multiple linear regression was used to analyze the relationship between hospitalization date and patient’s gender, age, area, payment method, , Hospital type 7 factors. Results There was no significant difference in hospitalization days between different sex groups, age groups and payment methods (t = 0.210, P = 0.834; F = 1.342, P = 0.252; 2χ = 5.945, P = 0.312) With the number of diagnosis, hospitalization days in different regions (Mann-Whitney test) were statistically significant (2χ = 52.489, P <0.001; 2χ = 32.924, P <0.001; t = -21.026, P <0.001; Z = -8.149 , P <0.001). Conclusions The hospitals should strengthen the management of surgical patients, strictly grasp the indications for surgery, optimize the design and management of surgical procedures for surgical patients, and conduct bidirectional referral service with primary hospitals to reduce the hospitalization day. At the same time, health authorities should guide the patients to rationally Select the place of medical treatment, do not blindly pursue the famous hospital, to avoid excessive concentration of a small number of hospital patients, which not only can effectively alleviate the difficulty of medical treatment is extremely expensive, but also to shorten the hospitalization days of patients have practical significance.