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Objective:To analyze the reform actions on raising the appropriateness of inpatient care use, as well as the current situation, so as to provide suggestions on improving the appropriateness.Methods:Policies and literatures on the appropriateness of inpatient care use released from 2009 to 2021 were collected from such official websites as the State Council and China National Health Commission as well as literature databases from home and abroad, for a text analysis. Based on the data of China Health Statistics Yearbook(2010-2021) and The Sixth National Health Service Survey Report (2018), descriptive methods were adopted to analyze the situation of inpatient care use in China. Results:Since the new healthcare reform, the Chinese government had standardized the hospitalization standards and procedures to minimize inappropriate use of inpatient care, increased financial subsidies for public hospitals to minimize their inappropriate patient attraction merely for economic interests, and reformed the medical insurance payment methods so as to regulate physicians′ behavior. Under the influence of the above policies, the average length of stay decreased from 10.5 days in 2009 to 9.1 days in 2019, with an average annual growth rate of -1.42%. The average waiting time in hospitals decreased from 3.6 days in 2008 to 1.5 days in 2018.From 2012 to 2019, the admission rate increased from 13.2% to 19.0%.Conclusions:Since the new healthcare reform, the average length of stay in China has decreased year by year, but the admission rate has increased year by year. Therefore, it is necessary to further reduce the inappropriate utilization of inpatient care use by speeding up the construction of the close-type medical alliances, improving the reform of payment methods, refining the performance appraisal standards for medical staff and strengthening supervision mechanism.
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The authors introduced the construction of one-stop admission service in a large general hospital.Measures were carried out by implementing the measures of one window handling of admission business, building one-stop pre-hospital preparation center, optimizing the operational pattern of pre-hospital examination, strictly controlling the hospitalization time of surgical patients, optimizing the information system according to admission criteria, providing personalized services for clinic and implementing quality monitoring.It effectively improved the pre-hospital examination rate, shortened the waiting time and the average length of stay of the patients undergoing elective surgery, and increased the satisfaction of pre-hospital patients.
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Background: Around 66% of infant and over 50% of under-five mortality occurs in newborn period. 99% of neonatal deaths occur in low and middle income countries. Most of these deaths can be prevented by suitable interventions at various levels. The premise of the study is that the neonates who require long transportation (>1 hour) have higher chances of mortality or prolonged stay in the hospital.Methods: A retrospective retrieval of data and prospective interview was conducted in G.B Pant children’s hospital Srinagar, an associated hospital of Govt. Medical College Srinagar in North India.Results: During the period of study 1431 neonates from twelve districts of the state were referred to the hospital for treatment, out of whom, 102 (7.13%) could not be saved. Neonatal death rate was found highest (11.11%) in neonates referred from districts of category-III (>100 kms from the referral hospital), followed by category-II (50-100 kms from the referral hospital) and category-I (>50 kms from the referral hospital). Average length of stay was observed longest for the neonates referred from districts of category-III followed by category-II and category-I.Conclusions: Several other studies found that transfer of sick neonates from another health facility were associated with relatively higher probability of morbidity and mortality after controlling for other predictors. Distance no doubt is a risk factor for neonatal outcome of referred neonates as we have observed in our study. To minimize neonatal deaths it is necessary to strengthen the perinatal services sick newborn care unit {(SNCUs) in district Hospitals)}.
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Objective Based on Health Economics, the author did research on influencing factors of hospital average length of stay. Method The author proposed theoretical hypothesis of average length of stay influencing factors from resource utilization rate, real capital, medical capital, services capability, labor input and proportion of medical technicians. And then, the author used panel data analysis method to do research on 2010—2015 Chinese 31 provinces influencing factors of hospital average length of stay on the data of China Health and Family Planning Statistics Yearbook. Result Hospital average length of stay is declining with each passing year. Resource utilization rate, services capability, labor input and proportion of medical technicians have a significant impact on hospital average length of stay. Conclusion Improving resource utilization rate, services capability, labor input and proportion of medical technicians will help shorten hospital average length of stay.
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Objective:Providing reference basis for effective shorten the average length of stay,this article analyses degree of the medical treatment index and the average length of stay.Methods:This article establishes a model of the weighted grey incidence of optimized grey entropy,and analyzes the influence of the medical treatment index for the average length of stay.Results:According to analyze correlation degree,the influence of the medical treatment index for the average length of stay in order of importance is open berths to count,bunk down times,treatment effectiveness,beds rate of utilization of hospital beds,annual outpatient service quantity,hospital surgery people number and discharge.Conclusions:Weighted grey incidence analysis method based on optimized grey entropy can effectively analyze influence degree of the medical treatment index for the average length of stay,and improving the quality of medical services.
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Objective To investigate the hospitalization cost,length of stay in hospital,and mortality in patients with pulmonary infection in a hospital,and evaluate the influencing factors,so as to provide scientific basis for mak-ing targeted infection control measures.Methods Medical records of patients with pulmonary infection between January 2011 and December 2012 were collected,the difference and influencing factors of hospitalization cost,aver-age length of stay,and prognosis among patients with different types of pulmonary infection were compared and an-alyzed by univariate analysis,multiple linear regression analysis,and logistic regression analysis.Results Of 10 431 patients with pulmonary infection,the average hospitalization cost was (29 081 .95 ± 38 682.92 )yuan (RMB),the median cost was 16 085.25 yuan(RMB),and the average length of stay was (15.93 ±20.54)d,the median was 13.00 d,a total of 828 patients died due to invalid treatment,mortality was 7.94%.There were signifi-cant differences in hospitalization cost,average length of stay among patients with different genders,ages,modes of payment,admission status of illness,types of pulmonary infection,and operation or not (all P <0.05),and the differences in mortality were also significant among patients of above characteristics except gender(all P <0.05 ). Influencing factors for hospitalization cost were as follows:length of stay,whether or not operated,modes of pay-ment,types of pulmonary infection(healthcare-associated pneumonia,HAP),age,gender,and so on,influencing factors for length of stay were whether or not operated and types of pulmonary infection,factors leading to death were admission condition, types of pulmonary infection (HAP ),and whether or not operated, and so on. Conclusion Control of healthcare-associated pulmonary infection is important for controlling hospitalization cost, shortening average length of stay,and improving survival rate of patients.
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Objective To explore the method of the major hospital indexes examination using clinical pathway as an opportunity.Methods Based on the material of our hospital from 2008 to 2010,reference the data of the same level hospital in Xinjiang Uygur Autonomous Region,we set the benchmark and formulated the examination standard of three examination indexes:average length of stay (ALOS),average hospitalization expense and drug proportion.Meanwhile,we took the subentry incentives to give the corresponding reward to clinical departments according to the decreases rate compared with the benchmark monthly.Results ALOS,average hospitalization expense and drug proportion of department and the whole hospital were obviously decreased compared with the same period last year,and the differences were statistically significant (Medical system:t =27.479,14.462,11.362,all P ＜ 0.01 ; Surgical system:t =18.944,16.029,12.071,all P ＜ 0.01).Conclusion After using the examination methods and combining clinical pathway,the effects are obvious,which can effectively shorten ALOS,reduce average hospitalization expense and drug proportion,so as to relieve the patients' economic burden.
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ObjectiveTo explore the determinants of average length of stay of three county hospitals and eleven countryside hospitals of Xinjiang province.MethodsRelative data of the county and the countryside hospitals from 2009 to 2010 were collected,and descriptive analysis and rank sum test were employed to explore the determinants of average length of stay.ResultsThe average length of stay of the county hospital was longer than the countryside hospital,the average length of stay had significant differences between the gender,age,and the disease classfication.ConclusionThe average length of stay of the county hospitals and countryside hospitals had difference significantly.
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Objective To identify the determinants of average length of stay of 16 upper first-class general hospitals from 2000 to 2007.Methods Relative data of 16 upper first-class general hospitals from 2000 to 2007 were collected, and descriptive analysis and multiple linear regression analysis were employed to explore the determinants of average length of stay. Results Operation ratio and days before operation of inpatients, ratio of salary to medical income, ratio of doctors to nurses, successful rescue rate in emergency, number of operation tables and staff had impact on average length of stay. Conclusion Resource allocation should be optimized, health care quality be enhanced, reasonable salary scheme be designed, and rational medical insurance policies be implemented in hospitals to shorten average length of stay.
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Objective To shorten the average length of stay for single disease entities and enhance the hospitals competitiveness through hospitalization process recombination while guaranteeing the quality of its medical service. Method The method of "systematic reintegration" from the theory of operation process recombination was adopted to recombine the hospitalization process for common disease entities in general surgery. Result After the recombination, the number of discharged patients with disease entities covered by the year 2000 research increased by 14.78%, the average length of stay was shortened by 3.83 days, a reduction of 21.58%, the average hospitalization fees incurred on the patients were reduced by 108 yuan, a reduction of 1.18%, and the business income increased by 13.43%, as compared with 1999, when recombination was not yet initiated. Conclusion Hospitalization process recombination can improve the quality and efficiency of a hospitals medical service and increase its business income while its medical service resources remain unchanged.