摘要
目的分析集中式管理模式下日间手术患者非计划重返住院的影响因素,为提高日间手术医疗质量和安全提供科学依据。方法回顾性收集2017年10月-2021年10月浙江大学医学院附属第二医院日间手术病房患者的数据,按照31 d内是否非计划重返住院分为非计划重返住院组和对照组,用多因素logistic回归模型分析患者31 d内非计划重返住院的影响因素。结果共纳入30636例患者,其中非计划重返住院46例,占0.15%。Logistic回归分析显示,男性[比值比(odds ratio,OR)=0.425,95%置信区间(confidence interval,CI)(0.233,0.776),P=0.005]、甲状腺手术[OR=19.938,95%CI(7.829,50.775),P<0.001]、胸腔镜下肺叶部分切除术[OR=13.481,95%CI(5.835,31.148),P<0.001]、腹腔镜下胆囊切除术[OR=10.593,95%CI(3.918,28.641),P<0.001]、痔切除术[OR=13.301,95%CI(4.473,39.550),P<0.001]是日间手术患者非计划重返住院的危险因素。结论日间手术病房的医护人员需对男性患者、高危术式患者加强监管,提高患者康复意识,以降低非计划重返住院率。
Objective To analyze the influencing factors of unplanned readmission for day surgery patients under the centralized management mode,and to provide a scientific basis for improving the medical quality and safety of day surgery.Methods The data of patients in the day surgery ward of the Second Affiliated Hospital Zhejiang University School of Medicine between October 2017 and October 2021 were retrospectively collected,and they were divided into an unplanned readmission group and a control group according to whether they were unplanned readmission within 31 days.Multivariate logistic regression model was used to analyze the influencing factors of patients’unplanned readmission within 31 days.Results There were 30636 patients,of which 46 were unplanned readmission patients,accounting for 0.15%.Logistic regression analysis showed that male[odds ratio(OR)=0.425,95%confidence interval(CI)(0.233,0.776),P=0.005],thyroid surgery[OR=19.938,95%CI(7.829,50.775),P<0.001],thoracoscopic partial lobectomy[OR=13.481,95%CI(5.835,31.148),P<0.001],laparoscopic cholecystectomy[OR=10.593,95%CI(3.918,28.641),P<0.001]and hemorrhoidectomy[OR=13.301,95%CI(4.473,39.550),P<0.001]were risk factors for unplanned readmission in patients undergoing day surgery.Conclusion Medical staff in day surgery wards need to strengthen supervision of male patients and high risk surgical patients,and improve patients’awareness of recovery,so as to reduce the rate of unplanned readmission.
作者
施水娟
蔡浩雷
楼正渊
张颖
谢美琪
张秀来
SHI Shuijuan;CAI Haolei;LOU Zhengyuan;ZHANG Ying;XIE Meiqi;ZHANG Xiulai(Department of Medical Administration,the Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou,Zhejiang 310009,P.R.China;Department of Hepatobiliary and Pancreatic Surgery,the Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou,Zhejiang 310009,P.R.China;Department of Science and Development,the Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou,Zhejiang 310009,P.R.China)
出处
《华西医学》
CAS
2022年第2期199-203,共5页
West China Medical Journal
关键词
日间手术
再入院
影响因素
Day surgery
readmission
influencing factors
