South M
Department of General Paediatrics, Royal Children's Hospital, Melbourne, VIC.
Med J Aust. 1997 Jul 7;167(1):11-3.
To examine changes to hospital admission rates, length of stay (LOS), bed use, and unplanned readmission rates for children with acute exacerbations of asthma following the change of the Victorian health care system to casemix funding.
Large university-affiliated children's hospital in Melbourne, Victoria.
Prospective collection of data from July 1989 to June 1996 for all children admitted with acute asthma (n = 11939).
The number of admissions for acute asthma showed a rising trend before the introduction of casemix funding in July 1993, and subsequently fell. There was a significant fall in mean LOS (64.5 to 39 hours; -40%; P = 0.001), and hence in bed-hours occupied for asthma (115370 to 61116; -47%; P = 0.001). There were no increases in unplanned readmission rates for asthma within the next seven or 14 days.
LOS and bed use for acute asthma at our hospital have been significantly reduced since the introduction of casemix funding, although this study does not prove a causal relationship. There was no increase in readmission rates, and thus no suggestion of any adverse effects as a result of reducing LOS. The 47% reduction in bed-hours should lead to large reductions in cost to the hospital.
研究维多利亚州医疗保健系统转变为病例组合付费制后，哮喘急性加重患儿的住院率、住院时间（LOS）、床位使用情况及非计划再入院率的变化。
维多利亚州墨尔本一家大型大学附属医院。
前瞻性收集1989年7月至1996年6月期间所有因急性哮喘入院患儿的数据（n = 11939）。
1993年7月引入病例组合付费制之前，急性哮喘的入院人数呈上升趋势，之后下降。平均住院时间显著缩短（从64.5小时降至39小时；-40%；P = 0.001），因此哮喘占用的床位小时数也显著减少（从115370降至61116；-47%；P = 0.001）。在接下来的7天或14天内，哮喘的非计划再入院率没有增加。
自引入病例组合付费制以来，我院急性哮喘的住院时间和床位使用显著减少，尽管本研究未证明因果关系。再入院率没有增加，因此没有迹象表明缩短住院时间会产生任何不良影响。床位小时数减少47%应会大幅降低医院成本。
