【摘要】 目的:提高医院平均住院日管理目标值设定的合理性以缩短住院日。方法:于某院病案系统导出2014—2016年出院患者相关数据,应用分类分析的数据挖掘方法,秉承"着眼近期兼顾过去及黄金分割"的原则,分科室按病种进行平均住院日的统计分析,制定出2017年全院及各科室平均住院日管理目标值体系。将该体系与绩效考核挂钩后加以实施,比较实施前后1年内的平均住院日情况。结果:该体系测算2017年全院平均住院日目标值应≤9.86天;重点管控科室为放疗科,平均住院日目标值≤17.10天,且该科重点管控病种为恶性肿瘤常规和术后放疗。实施该体系后,2017年4月至2018年3月全院平均住院日为9.76天,同比下降4.47%,P <0.01;放疗科平均住院日降至17.84天,同比下降8.79%,P<0.01。结论:基于数据挖掘确定平均住院日管理目标值的方法相对合理且可操作性强,可为医院平均住院日管理目标值体系的构建提供参考。更多还原

【Abstract】 Objective: To improve the rationality of target setting for average length of stay(ALOS) in hospital and eventually shorten ALOS. Methods: Related data of all patients discharged during 2014 to 2016 were derived from the medical record system in a tertiary hospital. The classification method was used to analyze the ALOS according to disease type for each department, and then the "golden section" principle "focusing on the recent and taking account of the past" was followed to formulate the ALOS target for the hospital and each department separately in 2017. The target values were integrated into performance appraisal and compulsively implemented.Finally, the ALOS before and after the implementation were compared. Results: The ALOS target for the whole hospital in 2017 was≤9.86 days. The key department to improve was the radiotherapy department, with the ALOS target of less than 17.10 days in 2017. Both routine and postoperative radiotherapy for malignant tumors were primary types of diseases to be improved in the department. After the implementation, from April 2017 to March 2018, the ALOS for the hospital decreased to 9.76 days(4.47%, P<0.01); and the ALOS for the radiotherapy department dropped to 17.84 days(8.79%, P<0.01). Conclusion:It suggests that target setting for ALOS based on data mining is reasonable and operable. This study might provide useful information for the management of ALOS in other hospitals.更多还原