使用生存分析的医疗住院患者住院时间的决定因素
Jaekyeong Kim1,2, Haegak Chang1, Seiyoung Ryu2
1School of Management, Kyung Hee University, Seoul 02447, Republic of Korea.
International journal of environmental research and public health
|November 27, 2024
概括
管理住院时间 (LOS) 对医疗保健费用至关重要. 这项研究使用了韩国大型数据集的生存分析,发现年龄,保险类型和医院类型显著影响LOS,告知资源管理.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
- 流行病学 流行病学
背景情况:
- 住院住院时间 (LOS) 管理对于控制医疗保健成本至关重要,特别是随着人口老龄化和保险覆盖范围的增加.
- 分析LOS的传统回归方法有局限性,包括未满足的假设和处理时间依赖变量的困难.
- 有效的管理需要对影响LOS的因素进行强有力的分析.
研究的目的:
- 确定韩国住院时间 (LOS) 的关键决定因素.
- 应用先进的统计方法,特别是生存分析,以克服先前研究的局限性.
- 为优化医疗保健资源分配和住院护理管理提供基于证据的见解.
主要方法:
- 利用了国家健康保险服务 (NHIS) 的样本队列数据 (2016-2019) 超过400万条记录.
- 采用卡普兰-梅尔生存估计来分析各种患者和机构特征的LOS概率.
- 应用了考克斯的比例危险模型来控制混因素,并验证了对LOS决定因素的发现.
主要成果:
- 社会人口结构因素 (年龄,性别),保险类型 (医疗援助) 和机构特征 (医院类型) 显著影响住院患者的LOS.
- 老年患者和医疗援助的接受者通常经历了更长的LOS.
- 与其他设施类型相比,一般医院的住院LOS较短.
结论:
- 生存分析提供了一种强大的方法,用于识别大型医疗保健数据集中的LOS决定因素.
- 影响LOS的关键因素包括患者人口统计,保险状况和医疗机构类型.
- 研究结果为制定有针对性的医疗保健政策提供了宝贵的见解,以提高效率和有效地管理住院资源.
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