Boasman Andrew, Jones Michael, Dyer Philip, Briggs Tim Wr, Gray William K
Getting It Right First Time Programme, NHS England, London, UK.
Getting It Right First Time Programme, NHS England, London, UK, and consultant physician in acute medicine, County Durham and Darlington NHS Foundation Trust, Durham, UK.
Future Healthc J. 2023 Nov;10(3):278-286. doi: 10.7861/fhj.2023-0014.
Emergency and acute hospital services in England are under increasing pressure. The aim of this study was to investigate the association between key case-mix indicators and outcomes for adults admitted to hospital with an acute medical condition in England. All patients aged ≥16 years admitted to hospital in England as an acute unselected medical admission and who survived to discharge during the financial year 2021-2022 were included. Length of hospital stay was the primary outcome of interest. Data were available for 1,586,168 unique patients. A case-mix index was developed with a score that ranged from 0 to 12. Frailty was the most important variable in the index, followed by multiple health conditions and patient age. The mean case-mix score across hospital trusts in England ranged from 5.3 to 7.8. The case-mix index will support initiatives to better understand factors contributing to outcomes from acute medical admissions to hospital.
英国的急诊和急性医院服务面临着越来越大的压力。本研究的目的是调查关键病例组合指标与在英国因急性疾病入院的成年患者结局之间的关联。纳入了所有年龄≥16岁、以急性非选择性医疗入院方式入住英国医院且在2021 - 2022财年存活至出院的患者。住院时间是主要关注的结局。有1,586,168名独特患者的数据可供使用。制定了一个病例组合指数，分数范围为0至12。虚弱是该指数中最重要的变量其次是多种健康状况和患者年龄。英国各医院信托机构的平均病例组合得分在5.3至7.8之间。病例组合指数将有助于开展相关举措，以更好地了解导致急性医疗入院患者结局的因素。
