上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（公共卫生） • 上一篇    下一篇

临床虚拟床位预住院模式的实践与探索

顾伟敏，王亚梓，丰青，包璇，陈海涛   

  1. 上海交通大学 医学院附属瑞金医院北院， 上海 201801
  • 出版日期:2015-11-28 发布日期:2016-01-13
  • 通讯作者: 陈海涛, 电子信箱: chenht_dr@hotmail.com。
  • 作者简介:顾伟敏（1967—）， 女， 统计师， 学士; 电子信箱: gwm14604@163.com。
  • 基金资助:

    上海申康医院发展中心临床管理优化项目（SHDC20136025）

Practice and exploration of clinical virtual beds pre-hospitalization mode

GU Wei-min, WANG Ya-zi, FENG Qing, BAO Xuan, CHEN Hai-tao   

  1. Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 201801, China
  • Online:2015-11-28 Published:2016-01-13
  • Supported by:

    Clinic Management Reform Project of Shanghai Hospital Development Center, SHDC20136025

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摘要：

目的  探索优化诊疗流程,实施虚拟床位预住院模式——以缩短临床术前平均住院日、减少患者部分医疗费用和提高医院管理效率为目的实践应用。方法  根据美国入院及住院日适当性评估方法（AEP）及借鉴业务流程重组（BPR）模式，结合国内医疗现状，建立新模式；运用独立样本t检验分析对普外科、泌尿外科4个试点病种进行差异性分析。结果  大隐静脉手术组、甲状腺手术组、腹腔镜下胆囊手术组3个试点病种在2014年采用虚拟床位预住院模式后实际住院天数、术前平均住院日、护理费均有显著差异（P<0.05）；大隐静脉手术组、甲状腺手术组及内镜下钬激光手术组患者医疗总费用有显著差异（P<0.05）。结论  美国AEP及BPR对于国内医疗行业现状具有参考意义，该院探索的虚拟化床位预住院模式具有一定现实意义，并在试点病种中取得较好成效，且存在持续改进优化空间，为探索虚拟化预住院模式提供可行性依据。

关键词: 术前平均住院日, 虚拟化床位, 预住院模式

Abstract:

Objective  To explore optimization of diagnosis and treatment procedure and implementation of virtual beds pre-hospitalization mode for reducing average hospital stay before clinical operation, decreasing medical expenses, and improving the management efficiency of hospital. Methods  According to business process reengineering (BPR) and appropriateness evaluation protocol (AEP) and combined with domestic medical situations, new mode was established. The difference analysis of four pilot diseases of the department of general surgery and department of urinary surgery was conducted by independent sample T-test. Results  The differences of actual hospital stay, average hospital stay before operation, and nursing expense of three pilot disease groups, i.e. great saphenous vein surgery group, thyroid surgery group, and laparoscopic cholecystectomy group, were significant after adopting the virtual beds pre-hospitalization mode in 2014 (P<0.05). The differences of total medical expense of great saphenous vein surgery group, thyroid surgery group, and endoscopic holmium laser surgery group were significant (P<0.05). Conclusion  The domestic medical industry can reference the AEP and BP. The virtual beds pre-hospitalization mode has certain practical significance and achieves good results for pilot diseases. The mode can be continuously optimized and can provide applicable evidences for studying the virtual pre-hospitalization mode.

Key words: average clinical preoperative length of stay, virtual beds, pre-hospital model