慢性肺病所需的住院时间
A I Mushlin1, E R Black, C A Connolly
1Department of Medicine, University of Rochester School of Medicine, NY.
JAMA
|July 3, 1991
概括
慢性肺病恶化的医疗必要住院时间平均为6-7天,与诊断相关组 (DRG) 分配不同. 临床因素可以预测COPD患者的逗留时间更长.
科学领域:
- 肺部医学 肺部医学
- 医疗保健服务研究 医疗服务研究
- 临床结果 临床结果
背景情况:
- 由于慢性肺病 (COPD) 恶化而入院,代表了医疗保健的重大负担.
- 准确预测所需停留时间 (LOS) 对资源分配和患者管理至关重要.
- 诊断相关组 (DRG) 系统被广泛用于补偿,但可能并不总是反映临床需求.
研究的目的:
- 为了确定COPD恶化的住院患者在医院住院的临床必要时间.
- 将医学确定的 LOS 与 DRG 系统分配的 LOS 进行比较.
- 在这个患者群体中确定预测更长时间住院的临床因素.
主要方法:
- 这是一项前性队列研究,涉及83名45岁以上的患者,他们因COPD恶化而入院,在两个急症医院接受治疗.
- 对并发症,关键事件的监测,以及对监测的需要,以确定医学上必要的LOS.
- 从医学上获得的LOS与DRG分配的LOS的统计比较.
- 在入院时对临床变量的分析,以预测LOS.
主要成果:
- 90%的患者在6天后没有并发症或需要监测.
- 医学上必要的平均LOS为6.9天,实际平均LOS为8.7天.
- 医学上必要的LOS和DRG分配的LOS之间的相关性很低,并且在统计学上没有显著意义.
- 高PCO2,症状>1天,以及抗生素治疗预测了更长的住院时间.
结论:
- 根据患者的临床事件,COPD恶化的临床指示LOS大约为6-7天.
- DRG系统的LOS计算可能与COPD患者的实际临床要求不一致.
- 在入院时确定特定的临床因素可以帮助预测哪些COPD患者需要长时间住院治疗.
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