上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2013, Vol. 33 ›› Issue (6): 754-.doi: 10.3969/j.issn.1674-8115.2013.06.011

• 专题报道（卫生系统研究） • 上一篇    下一篇

无效住院的研究进展

陶婧婧, 马 进   

  1. 上海交通大学 公共卫生学院， 上海 200025
  • 出版日期:2013-06-28 发布日期:2013-06-28
  • 通讯作者: 马进, 电子信箱: majin@shsmu.edu.cn。
  • 作者简介:陶婧婧（1988—）， 女， 硕士生; 电子信箱: vivien-jj@Hotmail.com。
  • 基金资助:

    国家自然科学基金（71273175）和上海市教委基金（13YS022）

Research progress of unnecessary hospitalization

TAO Jing-jing, MA Jin   

  1. School of Public Health, Shanghai Jiaotong University, Shanghai 200025, China
  • Online:2013-06-28 Published:2013-06-28
  • Supported by:

    National Natural Science Foundation of China，71273175；Shanghai Education Committee Foundation，13YS022

PDF (PC)

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摘要：

无效住院的存在增加了患者的疾病经济负担，降低了医疗资源的使用效率和医疗服务提供效率。文章对无效住院的相关文献报道进行了系统回顾，国内的理论研究将无诊疗行为、未能使患者从中受益的住院服务定义为无效住院；而在国外研究中，无效住院的范畴更为广泛，认为医院提供的低诊疗水平服务同样是无效住院，即无效住院包括住院服务提供过程中的无效和低效的部分。根据估算，无效住院导致的潜在经济负担约占政府预算支出的10%~15%，面对医疗服务使用过度与使用不足共存的问题，如何进行无效住院的系统研究、减少无效入院、降低无效住院日应当成为后续研究的重点，以便更好地提高卫生服务提供效率，优化医疗资源配置结构，进一步提高卫生保健的公平性和可及性。

关键词: 住院服务, 入院, 住院日, 适宜性

Abstract:

The presence of unnecessary hospitalization has aggravated the economic burden of patients, decreased the utilization efficiency of health resources, and reduced the supply efficiency of medical services. This paper undertakes the systemic review of relevant literatures on unnecessary hospitalization, and recognizes that the existing studies in China generally consider the hospital stay that can not provide material benefits to patients or achieve the expected results is unnecessary. On the other hand, the concept of unnecessary hospitalization is much wider in the foreign researches, considering in-patient stay with low cost-effectiveness is also unnecessary, and unnecessary hospitalization incorporates the low-effective and ineffective parts in the in-patient services. According to the estimation, the extent of latent economic burden resulting from unnecessary hospitalization is 10% to 15% of the government budget expenditure on health care. Facing the existence of overuse and underuse of health care, it should be a focus to conduct the unnecessary hospitalization research and reduce unnecessary services without compromising the quality of inpatient services, in order to further improve the provision efficiency of medical services, optimize the medical resource allocation structure, and finally widen the equity and accessibility of health care.

Key words: hospital services, admission, hospital day, appropriateness