老年脑梗死患者社会化住院现状及影响因素分析

doi:10.3761/j.issn.0254-1769.2019.02.006

摘要/Abstract

摘要：

目的分析老年脑梗死患者“社会化住院”现状及其影响因素。方法采用回顾性研究方法收集420例汕头市某三级甲等医院2015年9月—2016年9月老年脑梗死住院患者的病历信息,采用Logistic回归分析“社会化住院”的影响因素。结果年龄≥65岁的脑梗死患者中,“社会化住院”患者达21.80%,其医疗费用占总费用的39.64%,住院天数占总住院天数的39.40%。Logistic回归分析结果显示,医院获得性感染和达出院标准时ADL水平是“社会化住院”的影响因素。患者达到出院标准时ADL水平与住院天数和医疗费用有关（P<0.001）。结论 “社会化住院”占用大量医疗资源。减少医院获得性感染,促进患者早期康复,提高患者达到出院标准时的ADL水平有利于减少“社会化住院”的发生。

关键词: 社会化住院, 脑梗死, 老年人, 影响因素分析, 护理管理研究

Abstract:

Objective To analyze the current status and risk factors of “social hospitalization” among elderly patients with stroke. Methods Retrospective survey was used to collect relevant data from 420 medical records of hospitalized elderly patients with stroke,from September 2015 to September 2016 in a tertiary hospital in Shantou. Logistic regression analysis was used to analyze the influencing factors. Results The rate of “social hospitalization” was 21.80% among investigated elderly patients with stroke,while their hospital medical expenses accounted for 39.64% of overall expenses and the length of stay accounted for 39.40%. Multiple logistic regression showed that hospital-acquired infection,and activities of daily living when meeting discharge criteria were risk factors for “social hospitalization”. Activities of daily living when meeting discharge criteria were correlated with length of stay and medical expenses（P<0.001）. Conclusion Huge amounts of medical sources were consumed by “social hospitalization”. Reducing hospital-acquired infection,promoting early rehabilitation,improving activities of daily living when meeting discharge criteria will help reduce “social hospitalization”.

Key words: Social Hospitalization, Cerebral Infarction, Aged, Root Cause Analysis, Nursing Administration Research

古楚儿,彭刚艺,应文娟,苏静. 老年脑梗死患者社会化住院现状及影响因素分析[J]. 中华护理杂志, 2019, 54(2): 194-198.

GU Chuer,PENG Gangyi,YING Wenjuan,SU Jing. Current status and risk factors of “social hospitalization” among elderly stroke patients[J]. Chinese Journal of Nursing, 2019, 54(2): 194-198.

图/表 4

表1 “社会化住院”影响因素的单因素分析结果[n=353,例(百分比,%)]

表2 自变量赋值表

表3 “社会化住院”影响因素Logistic回归分析结果

表4 达到出院标准ADL水平与占用医疗资源关系(n=353)

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