Han Kyu-Tae, Kim Sun Jung, Jang Sung-In, Kim Seung Ju, Lee Seo Yoon, Lee Hyo Jung, Park Eun-Cheol
Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Department of Health Administration, Namseoul University, Cheonan, Republic of Korea.
J Neurol Sci. 2015;353(1-2):137-42. doi: 10.1016/j.jns.2015.04.034. Epub 2015 Apr 29.
Cerebrovascular diseases are the second-highest cause of death in South Korea (9.6% of all causes of mortality in 2013). South Korea has a shortage of trained medical personnel compared with other countries and the demands for health care are continuously increasing. Our study sought to determine the relationship between hospital human resources and the outcomes of stroke patients.
We used data from NHI claims (n=99,464) at 120 hospitals to analyze readmission or death within 30 days after discharge or hospitalization for stroke patients during 2010-2013. We used multilevel models that included both patient-level and hospital-level variables to examine factors associated with readmission or death within 30 days.
A total of 1782 (1.8%) patients were readmitted within 30 days, and death occurred within 30 days for 6926 (7.0%) patients. Patients cared for by a higher percentages of specialists or registered nurses had a lower risk of readmission or death within 30 days (readmission per 10% increase in registered nurses, OR=0.89 and SD=0.85-0.94; death per 10% increase in specialists, OR=0.93 and SD=0.89-0.98).
The percentages of specialist and registered nurses caring for stroke patients were positively correlated with better patient outcomes, particularly for patients with cerebral infarction.
脑血管疾病是韩国第二大致死原因（2013年占所有死亡原因的9.6%）。与其他国家相比，韩国受过专业培训的医务人员短缺，且医疗保健需求持续增加。我们的研究旨在确定医院人力资源与中风患者治疗结果之间的关系。
我们使用了120家医院的国家健康保险索赔数据（n = 99,464），分析2010 - 2013年期间中风患者出院或住院后30天内的再入院或死亡情况。我们使用了包含患者层面和医院层面变量的多层次模型，以检查与30天内再入院或死亡相关的因素。
共有1782名（1.8%）患者在30天内再次入院，6926名（7.0%）患者在30天内死亡。由较高比例的专科医生或注册护士护理的患者在30天内再入院或死亡的风险较低（注册护士每增加10%，再入院的比值比[OR]=0.89，标准差[SD]=0.85 - 0.94；专科医生每增加10%，死亡的OR = 0.93，SD = 0.89 - 0.98）。
护理中风患者的专科医生和注册护士的比例与更好的患者治疗结果呈正相关，尤其是对于脑梗死患者。
