| 蒲兴翠,宁宁,李佩芳.骨科病人未手术出院原因分析与对策.骨科,2019,10(4): 348-352. |
| 骨科病人未手术出院原因分析与对策 |
| Causes of un-surgical discharge of orthopaedic patients and countermeasures |
| 投稿时间：2018-09-28 |
| DOI：10.3969/j.issn.1674-8573.2019.04.018 |
| 中文关键词: 未手术，出院 术前管理 医疗质量 |
| 英文关键词: No surgery, discharged Preoperative management Medical quality |
| 基金项目:四川省科技厅支撑项目（2018SZ0228） |
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| 中文摘要: |
| 目的 分析骨科病人未手术出院的原因，为进一步优化病人入院和提高医疗资源的使用率提供依据。方法 回顾性研究2016年12月至2017年11月我院骨科未行手术即出院病人的病历资料，记录未手术出院的原因并对其进行分析。结果 共收治入院病人8 667例，其中急诊入院病人1 288例；未手术出院病人790例（9.12%，790/8 667），未手术出院急诊病人249例（19.33%，249/1 288）。未手术出院病人与手术出院病人之间的不同年龄段、不同病种和不同婚姻状况比较，差异均有统计学意义（P均＜0.05）。未手术出院原因为保守治疗、合并症、感染、无需手术治疗、术前准备不充分、血栓和其他原因。结论 制定一套切实可行的入院标准和术前管理，通过明确诊断、针对性的院前检查、详细的院前通知和严格的院内收治等措施，尽量减少病人未手术出院的发生，切实提高医疗资源的使用率，提高整体医疗质量。 |
| 英文摘要: |
| Objective To analyze the causes of unplanned discharge in patients with orthopaedic surgery and to find out the commonalities among them, so as to provide basis for further optimizing the admission of patients and improving the utilization efficiency of medical resources. Methods We retrospective reviewed the medical records of patients who were discharged surgeries in our department from December 2016 to November 2017, and recorded the reasons for the unplanned discharge and analyzed them. Results There were 8 667 patients who were admitted to hospital, including 1 288 emergency patients. There were 790 patients who were discharged without surgery (9.12%, 790/8667), including 249 emergency patients who were discharged without surgery (19.33%, 249/1 288). There were significant differences between un-surgical discharged patients and surgical discharged patients of different age groups, different diseases and different marital status (all P＜0.05). The common causes of un-surgical discharge were conservative treatment, complications, infection, not needing surgery, unsufficient preoperative preparation, thrombosis and other causes. Conclusion It is necessary to establish a set of feasible admission criteria and preoperative management for patients admitted to hospital. Through correct diagnosis, targeted pre-hospital examination, detailed pre-hospital notification and strict hospital admission, we could minimize the occurrence of unplanned discharge without surgery to improve the efficiency and quality of medical resources. |
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