Madsen Flemming, Ladelund Steen, Linneberg Allan
Flemming Madsen (
Steen Ladelund is a statistician at the Clinical Research Centre, Hvidovre University Hospital, in Hvidovre, Denmark.
Health Aff (Millwood). 2014 Jul;33(7):1236-44. doi: 10.1377/hlthaff.2013.1303.
High bed occupancy rates have been considered a matter of reduced patient comfort and privacy and an indicator of high productivity for hospitals. Hospitals with bed occupancy rates of above 85 percent are generally considered to have bed shortages. Little attention has been paid to the impact of these shortages on patients' outcomes. We analyzed all 2.65 million admissions to Danish hospitals' departments of medicine in the period 1995-2012. We found that high bed occupancy rates were associated with a significant 9 percent increase in rates of in-hospital mortality and thirty-day mortality, compared to low bed occupancy rates. Being admitted to a hospital outside of normal working hours or on a weekend or holiday was also significantly associated with increased mortality. The health risks of bed shortages, including mortality, could be better documented as a priority health issue. Resources should be allocated to researching the causes and effects of bed shortages, with the aim of creating greater interest in exploring new methods to avoid or reduce bed shortages.
高床位占用率一直被认为会降低患者的舒适度和隐私,同时也是医院高生产率的一个指标。床位占用率高于85%的医院通常被认为床位短缺。这些短缺对患者治疗结果的影响却很少受到关注。我们分析了1995年至2012年期间丹麦医院内科所有265万例住院病例。我们发现,与低床位占用率相比,高床位占用率与住院死亡率和30天死亡率显著增加9%相关。在正常工作时间之外、周末或节假日入院也与死亡率增加显著相关。床位短缺带来的健康风险,包括死亡率,可以作为一个优先健康问题得到更好的记录。应分配资源研究床位短缺的原因和影响,以提高对探索避免或减少床位短缺新方法的关注度。