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哪些因素影响尼日利亚一家三级医院中风患者的平均住院时间?

What factors influence the average length of stay among stroke patients in a Nigerian tertiary hospital?

作者信息

Somotun Olasheni Abdul-Afeez, Osungbade Kayode Omoniyi, Akinyemi Oluwaseun Oladapo, Obembe Taiwo Akinyode, Adeniji Folashayo Ikenna

机构信息

Association for Reproductive and Family Health, Uyo, Nigeria.

Department of Health Policy and Management, College of Medicine, University of Ibadan, Ibadan, Nigeria.

出版信息

Pan Afr Med J. 2017 Apr 25;26:228. doi: 10.11604/pamj.2017.26.228.12249. eCollection 2017.

Abstract

INTRODUCTION

Increased emphasis is being laid on ensuring that health resources are efficiently utilized, especially in resource-constrained settings such as in Nigeria. One of the main indices of how efficiently a health institution is being run is Length of Stay (LOS), which is likely to be higher in chronic diseases such as stroke and diabetes. Stroke is a chronic disease that is currently on the rise in Low and Middle income countries (LMICs) who are also characterized by constraint of health resources. This study seeks to determine the LOS of stroke patients as well as factors that affect it.

METHODS

A retrospective analysis of health records of stroke victims admitted into the medical wards of the University College Hospital, Ibadan between January 2012 and December 2014 was conducted. Data on sociodemographic information, comorbidities and risk factors were extracted while LOS was calculated by counting the number of days the patient was admitted. Analysis was carried to using SPSS.

RESULTS

A total of 143 records were used in the final analysis with 53.1% of them being males and having a mean age of 61.5 ± 14.2 years. More than half (53.8%) of the cases were ischemic strokes. The average length of stay was 13.7 ± 8.9 days while bivariate analysis showed that a greater proportion of cases who consumed alcohol, had diabetes and hypertension had LOS of over 7 days than those who did not. However, these differences in proportions were not statistically significant (0.310<<0.883).

CONCLUSION

LOS of stroke patients in Nigeria was shown to be prolonged especially when compared to similar settings in West Africa. The high prevalence of some of the risk factors of stroke such as diabetes mellitus indicates that policy and advocacy to drive changes in lifestyle are necessary to reduce the incidence of stroke and its consequent burden on health systems.

摘要

引言

人们越来越重视确保卫生资源得到有效利用,尤其是在尼日利亚等资源有限的地区。衡量卫生机构运营效率的主要指标之一是住院时间(LOS),在中风和糖尿病等慢性病中,住院时间可能会更长。中风是一种慢性病,目前在低收入和中等收入国家(LMICs)呈上升趋势,这些国家的特点也是卫生资源有限。本研究旨在确定中风患者的住院时间及其影响因素。

方法

对2012年1月至2014年12月期间入住伊巴丹大学学院医院内科病房的中风患者的健康记录进行回顾性分析。提取社会人口学信息、合并症和危险因素的数据,同时通过计算患者住院天数来计算住院时间。使用SPSS进行分析。

结果

最终分析共使用了143份记录,其中53.1%为男性,平均年龄为61.5±14.2岁。超过一半(53.8%)的病例为缺血性中风。平均住院时间为13.7±8.9天,双变量分析显示,饮酒、患有糖尿病和高血压的患者中,住院时间超过7天的比例高于未患这些疾病的患者。然而,这些比例差异无统计学意义(0.310<<0.883)。

结论

尼日利亚中风患者的住院时间较长,尤其是与西非的类似情况相比。中风的一些危险因素如糖尿病的高患病率表明,推动生活方式改变的政策和宣传对于降低中风发病率及其对卫生系统的后续负担是必要的。

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