Quinn M P, Courtney A E, Fogarty D G, O'reilly D, Cardwell C, McNamee P T
Regional Nephrology Unit, Level 11, Belfast City Hospital, 51 Lisburn Road, Belfast BT97AB, UK.
QJM. 2007 Sep;100(9):561-6. doi: 10.1093/qjmed/hcm064. Epub 2007 Jul 30.
Effective bed use is crucial to an efficient NHS. Current targets suggest a decrease in mean occupancy as the most appropriate method of improving overall efficiency. The elderly and those suffering from complex medical problems are thought to account for a high proportion of overall bed occupancy.
To assess the effect of prolonged hospital stay (>100 days) on overall bed occupancy in a modern teaching hospital.
Retrospective analysis.
Analysis of all admission episodes (n = 117,178) over a five-year period in a large teaching hospital in a single UK region, serving a population of approximately 200,000. A logistic regression multi-factorial model was used to assess the effect of demographic and diagnostic variables on duration of stay.
A prolonged stay (>100 days) was seen in 648 admission episodes (0.6%). These accounted for 11% of the overall bed occupancy over the 5-year period. Excluding all prolonged admission episodes from our analysis made no difference to the overall median length of stay.
Prolonged hospitalizations have a significant impact on bed occupancy. Targeting these very long (>100 days) hospital stays may better improve overall efficiency, compared to targeting mean or median length of stay.
有效的床位利用对高效的国民医疗服务体系至关重要。当前目标表明,降低平均占用率是提高整体效率的最合适方法。老年人和患有复杂医疗问题的人被认为在总床位占用中占很高比例。
评估在一家现代教学医院中延长住院时间(>100天)对总床位占用的影响。
回顾性分析。
对英国一个地区一家大型教学医院五年内的所有入院病例(n = 117,178)进行分析,该地区人口约20万。采用逻辑回归多因素模型评估人口统计学和诊断变量对住院时间的影响。
648例入院病例(0.6%)出现了延长住院时间(>100天)的情况。这些病例在5年期间占总床位占用的11%。在我们的分析中排除所有延长住院病例对总体中位住院时间没有影响。
延长住院时间对床位占用有重大影响。与针对平均或中位住院时间相比,针对这些非常长(>100天)的住院时间可能会更好地提高整体效率。