不恰当的住院作为后续不良事件发展的风险因素:一个横截面研究
Diego San Jose-Saras1,2, Jorge Vicente-Guijarro3,4, Paulo Sousa5
1Preventive Medicine and Public Health Service, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain.
BMC medicine
|August 17, 2023
概括
不适当的入院 (IHA) 显著增加了患者发生不良事件 (AE) 的风险. 这些事件导致更长的重症监护室停留时间和大量的财务成本.
科学领域:
- 医疗保健质量和患者安全研究.
- 医院管理和健康经济学.
背景情况:
- 过度利用医疗保健服务,包括住院治疗,可能会使患者面临不必要的不良事件风险.
- 量化不适当入院 (IHA) 对后续AE的影响的直接证据是有限的.
研究的目的:
- 分析不适当入院 (IHA) 和随后不良事件 (AE) 的发生之间的关联.
- 与适当的入院相比,探索IHA后AEs的独特临床和经济影响.
主要方法:
- 一项涉及西班牙马德里558名住院患者的观测横截面研究.
- 使用适当性评估协议来识别IHA.
- 采用哈佛医学实践研究和欧洲点患病率调查的方法来检测和描述AE.
主要成果:
- 不适当的住院 (IHA) 与后续不良事件 (AE) 风险增加3.54倍有关.
- 在IHA之后的AE在预定入院中更为常见 (78.9%对27.9%),并导致平均2.4个额外的ICU日.
- 在IHA之后的AE为研究样本增加了166,324.9欧元的额外成本.
结论:
- 经历不适当入院 (IHA) 的患者面临更高的后续不良事件 (AE) 风险.
- IHA被确定为可能导致AE的潜在因素,AE是多因素的.
- 与IHA相关的AE与预定入院,长时间的ICU停留和显著的成本超支有关.
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