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- 2018
基于疾病诊断相关分组特点的手术部位感染管理
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Abstract:
摘要 目的 通过分析手术部位感染病例与疾病诊断相关分组(DRGs)的关联性,旨在有针对性地采取干预措施,降低医院感染的发生率.方法 分析某医院的手术部位感染病例DRGs的集中趋势,并利用病例组合指数(CMI)进行风险调整,使疾病严重程度不同的病例组之间具有可比性.应用 x2检验对各科室间的手术部位感染率以及各科室不同DRGs间手术部位感染率进行比较分析.结果 排名前5位科室感染例数占总感染数的73.7%,取手术部位感染患者数在2例及以上的DRGs进行分析,96例感染患者主要集中在22个DRGs,占199例感染患者的48.24%.除神经外科外,其他科室中不同DRGs的风险调整后感染率之间均有统计学差异(P<0.05).单位CMI感染率最高的组别为:普外科GF13(7.72%)、肝胆外科HD33(8.44%)、创伤骨科ID23(8.30%)、脊柱骨科IB13(1.28%).结论 手术患者医院感染在DRGs中具有集中趋势,可通过对手术部位感染集中的DRGs进行根因分析,有针对性地干预,降低医院感染的发生.
| [1] | 简伟研, 汤淑女, 胡牧. 北京地区公立综合医院规模和住院服务产出关系的的实证分析[J]. 北京大学学报(医学版), 2011, 43(3): 102-105. |
| [2] | JIAN W Y, TANG S N, HU M.Empirical analysis of relationship between scales and outputs of inpatient services of public comprehensive hospitals in Beijing area[J]. Journal of Peking University(Health Sciences), 2011, 43(3): 102-105. |
| [3] | 邓小红, 张大发, 吕飞宇, 等. 北京DRGs-PPS的组织实施[J]. 中华医院管理杂志, 2011, 27(11): 809-812. |
| [4] | WANG Y N, FENG Z H, Xü L, et al.Molecular typing and antimicrobial susceptibility of methicillin-resistant staphylococcus aureus isolates from Southwest Hospital of Chongqing[J]. Journal of Jinan University(Natural Science & Medicine Edition), 2016, 37(6): 481-487. |
| [5] | 徐锡武, 李珑, 陈彤, 等. 基于DRGs相关指标的临床科室医疗能力评估体系构建与检验[J]. 中华医院管理杂志, 2014, 30(7): 506-510. |
| [6] | HUGHES B D, MEHTA H B, SIELOFF E, et al.DRG migration: A novel measure of inefficient surgical care in a value-based world[J]. AM J SURG, 2018, 215(3): 493-496. |
| [7] | 王轶男, 凤梓涵, 徐磊, 等. 重庆西南医院骨科感染金黄色葡萄球菌的分子分型及耐药性研究[J]. 暨南大学学报(自然科学与医学版), 2016, 37(6): 481-487. |
| [8] | DENG X H, ZHANG D F, LV F Y, et al.Establishing organization of diagnosis related groups and prospective payment system in Beijing[J]. Chin J Hosp Admin, 2011, 27(11): 809-812. |
| [9] | TOSATTO L, BENNETT B A V,SMOOKE M D. Comparison of different DRG-based methods for the skeletal reduction of JP-8 surrogate mechanisms[J]. Combustion and Flame, 2013, 160(9): 1572-1582. |
| [10] | DAWSON N, BURTON M C, HULL B, et al.Relation of telemetry use and mortality risk, hospital length of stay, and readmission rates in patients with respiratory illness[J]. Am J Cardiol, 2017, 120(8): 1416-1420. |
| [11] | 付雪松, 曾惠敏, 张霁, 等. 根因分析法在医院感染漏报病例管理中的作用[J]. 中国医院, 2017, 21(8): 47-49. |
| [12] | FU X S, ZENG H M, ZHANG J, et al.The effect of root cause analysis in the missing report management of nosocomial infection cases[J]. Chinese Hospitals, 2017, 21(8):47-49. |
| [13] | Xü X W, LI L, CHEN T, et al.Building of the medical capacity evaluation system using DRGs-related indexes in clinical departments and its tests[J]. Chin J Hosp Admin, 2014, 30(7): 506-510. |
| [14] | OR Z.Implementation of DRG Payment in France: Issues and recent developments[J]. Health Policy, 2014, 117(2): 146-150. |
| [15] | FOURIE C, ANDOMO N B, WILD V.Systematically evaluating the impact of diagnosis-related groups (DRGs) on health care delivery: A matrix of ethical implications[J]. Health Policy, 2014, 115(2/3): 157-164. |
