科研之友
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摘要
Background Over prolonged hospitalization in elderly patients due to physical decline and characteristics of geriatric diseases has put great pressure on the resources of emergency beds in tertiary medical institutions.Under the current situation of shortage of medical resources,studying the status of over prolonged hospitalization in elderly patients is of great significance to promote the rational allocation of resources,and improve the effective utilization of medical resources as well as the elderly's satisfaction with medical services.Objective To analyze the status and influencing factors of over prolonged hospitalization in elderly patients based on a survey,to provide evidence-based data for formulating prevention and control measures to shorten the length of hospitalization in this group.Methods A retrospective design was adopted.By checking the information on the medical records homepage,data of 686 elderly patients(≥ 60 years) who hospitalized for more than 30 days during 2016 to 2018 in Chongzhou People's Hospital were collected and analyzed.Multiple linear regression analysis was used to identify the factors affecting the length of hospitalization in these patients.Results During the period,these participants accounted for 0.66%(686/104 068) of the total cases discharged from the hospital,with hospitalized days accounting for 3.74%(32 982/881 872) of the total.Most of the participants〔343 cases(50.0%)〕hospitalized for 31 to 39 days,mainly in rehabilitation department 〔293 cases(42.7%)〕,with circulatory system disease as the most common disease〔247 cases(36.0%)〕,(7.7±3.4) complications on average,(4.5±1.7) systems affected by complications on average,mean MCIRS-G score of(24.8±4.0),chronic disease prevalence of 95.6%(656/686),(5.4±2.9) chronic diseases on average,and hypertension as the most common chronic disease〔515 cases(75.1%)〕.The results of multiple linear regression analysis showed that age(β=-5.057),rescue times(β=2.675),nosocomial infection(β=4.245) and MCIRS-G score(β=5.389) were important factors affecting the length of stay(P<0.05).Conclusion The factors influencing the length of stay in elderly patients include age,times of rescue,nosocomial infection and comorbidity burden.To shorten the length of stay in these patients,recommendations are put forward as follows:Constructing an integrated medical and nursing care system,developing the multidisciplinary collaborative diagnostic and therapeutic and care,strengthening the management of key geriatric diseases,attaching great importance to the development of geriatric medicine and improving hospital-based management of geriatric diseases.
- 出版日期2020
