急诊患者留观病房滞留时间影响因素及分析.pdf

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1、MedicalManagement急诊患者留观病房滞留时间影响因素及分析InfIuencinqfactorsandAnalysisofResidenceHoursin—ObservationWardsforEmergencyPatients口杨伟英YangWei—ying施欢欢ShiHuan—huan陈建萍ChenJian—ping孙美萍SunMei—ping、>目的了解急诊住院患者在留观病房滞留的影响因素，为加快患者的分流提供依据。方法回顾性分析一家地方综合性医院2013年经急诊留观病房收住院患者的信息，通过单因素方差分析和Logist

2、ic回归分析研究影响患者在留观病房滞留的危险因素。结果(1)全年经急诊留观病房收住院的患者有3116例，留观病房滞留时间中位数、四分位间距为59小时(24～92)，有32．1％的患者留观病房滞留时间大于72小时。(2)单因素分析显示影响患者滞留的最主要的影响因素是年龄、病情是否涉及多个科室、诊断数、收治科室，其他因素依次为性别、就诊月份、留观方式、收留观时间段。(3)LogiStiC回归分析提示，最主要的影响因素有收治科室、年龄、就诊月份、留观时间段和性别结论该家医院急诊留观患者滞留时间偏长，主要受专科收治科室、年龄、就诊月份等因素影响，

3、患者的主观因素值得重视并进一步研究。Abstract：ObjectiveExploredtheinfluencingfactorsofemergencyinpatientsdetainedinobservationwardsandprovidedbasisfortheimprovementofpatientsshunt．MethodsRetrospectivelyanalyzedoftheinpatientsfromtheemergencyobservationwardsinalocaltertiaryhospitalin2013ands

4、tudiedtheriskfactorsthatinfluencedemergencyinpatientsdetainedinobservationwardsbymeansofbinarylogisticregression．Results(1)Atotalof3116inpatientswereadmittedfromemergencyobservationwards．Themedianandquartileofresidencehoursinobservationwardswas59h(24-92)．32．1％ofthepatient

5、sdetainedinemergencyobservationwardsmorethan72h．(2)Univariateanalysisshowedthatthemajorfactorscontributingtoresidencehourswereage，whetherdiseasesinvolvingmultipledepartments，thenumberofinitialdiagnosisandadmissiondepartment．Otherfactorsincludedgender，visitmonth，thewayofob

6、servationandtheobservationhour．(3)Binarylogisticregressionshowedthatthemainfactorscontributingtoresidencehourswereadmissiondepartment，age，visitmonth，theobservationhourandgender．ConclusionTheresidencetimeofemergencypatientsforobservationinthishospitalwasmuchlonger，whichwas

7、mainlyaffectedbyadmissiondepartment，age，visitmonthandSOon．Subjectivefactorsofpatientsshouldbedrawnattentionandbefurtherstudied．关键词Keywords：急诊Emergency；留观病房Observationwards；影响因素Influencingfactors；二分类Logistic；回归分析BinaryLogisticregression＼／急诊拥挤现象(emergencydepartmentcrowding)

8、指急诊需要住院但无床位，以及接受治疗但病情未能稳定等急诊患者。患者的需求(即等待急诊临床决策，如分诊、候诊、留观、治疗、浙江省质量控制中心检查标准及三级甲等医院综合性医院检查安置等)超过了急诊