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目前有些医院在抓管理、抓缩短平均住院日的工作中,采用了十分有效的途径,使出院患者的平均住院日大幅度降低。但从计算方法到该指标的反映上来看,则不能真实地反映住院者的平均住院日。例如设立日间病房,其有利方面是分流病人,平均住院日缩短;其不利方面是重复计数,并且导致重复疾病编码分类。这些日间病房的床位是从医院的固定编制床位中分离出一小部分,在全院实际开放床位中占有一定比例,并配备专职医护人员和相应设备。患者从入至出日间病房的检查、观察等管理流程同正规病房的医护制度一样。这种日间病房主要收治术前检查或术后观察,以及急性病症或观察几日的患者。日间病房以周转快,检查治疗及时的特点,有它的优势。但因在实际开放床位中占有一定比例,计算总体床位的患者平均住院日时,其指标明显缩短,同时走进了缩短平均住院日的误区。
At present, some hospitals have adopted very effective methods in the management and shortening of the average length of stay, which has greatly reduced the average length of hospital stay for discharged patients. However, from the calculation method to the reflection of this indicator, it can not truly reflect the average hospital stay of the residents. For example, the establishment of day wards has the advantage of diverting patients and shortening the average length of stay; its unfavorable aspect is repeated counting and leads to repeated disease coding and classification. The beds in these day wards are a small part of the hospital’s fixed establishment beds, occupy a certain percentage of the actual open beds in the hospital, and are equipped with full-time medical personnel and corresponding equipment. The management procedures for the examination and observation of the patients from the day of arrival to the daytime are the same as those of the regular wards. This kind of day ward mainly treats preoperative examinations or postoperative observations, as well as acute illnesses or patients who are observed for several days. The daily wards have the advantages of rapid turnover, timely inspection and treatment and their advantages. However, because of the proportion of actual open beds, when calculating the average length of stay for patients in the overall bed, the indicators were significantly shortened, and at the same time, they entered the shortcomings of shortening the average length of stay.