Length of Stay and Its Affecting Factors in a General Hospital of a Multiple Nationality City in Western China

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Li Fang, Wei Yi Yang, Hui Ling Liu, Zi Yang Fang, Qian Li Tang, Jin Hua Wang, Ren Rong Gong
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Abstract

Background

Length of stay (LOS) serves as a key metric for assessing hospital efficiency. However, LOS is complex and multidimensional, and influenced by various factors that require further explorations. The purpose of the present study was to examine factors and their interactions affecting LOS in a general hospital in western China.

Methods

This cross-sectional study involved 9631 cases admitted to a tertiary general hospital in Guangxi province, China, from December 2018 to October 2020. LOS and 17 additional variables were collected from the Hospital Information System and integratively analyzed. As a novel factor created in the current study, agreement between admission and discharge departments was evaluated by comparing the admission department with the discharge department. Kruskal–Wallis and Mann–Whitney U tests were used to analyze the relationship of LOS with other variables. Multiple linear regression was employed to identify predictors of LOS.

Results

Variations in LOS were noted among patients based on gender, occupation, patient sources, contact persons, admission types, discharge types, disease severity types or medical payment methods, or patients with or without agreement between admission and discharge departments, the presence of hospital acquired infections (HAI) or antibiotic usages. No significant differences were found related to nationalities, marital statuses, patients with or without agreement between outpatient and discharge diagnoses, or agreement between admission and discharge diagnoses. Moreover, the number of hospitalizations, admission type, discharge type, disease severity type, agreement between admission and discharge departments, HAI, antibiotic usage, and medical payment method significantly predicted LOS, while others did not. The direct effects of agreement between admission and discharge departments on LOS were 86.88% of the total effects.

Conclusion

Factors affecting LOS were observed in the hospital, including agreement between admission and discharge departments. Recommendations should focus on resource allocation and optimization in decision-making to direct patients to suitable departments while improving other critical factors.

西部某多民族城市综合医院住院时间及其影响因素分析
住院时间(LOS)是评估医院效率的关键指标。然而,LOS是复杂的、多维的,受多种因素的影响,需要进一步探索。本研究的目的是探讨影响中国西部某综合医院LOS的因素及其相互作用。方法对2018年12月至2020年10月在广西某三级综合医院住院的9631例患者进行横断面研究。从医院信息系统中收集LOS和其他17个变量并进行综合分析。通过对入院科室与出院科室的比较来评价入院科室与出院科室的一致性,是本研究新增的一个因素。采用Kruskal-Wallis检验和Mann-Whitney U检验分析LOS与其他变量的关系。采用多元线性回归来确定LOS的预测因素。结果不同性别、职业、患者来源、接触者、入院类型、出院类型、疾病严重程度类型、医疗支付方式、住院与出院部门是否有协议、是否存在医院获得性感染(HAI)或抗生素使用等因素导致患者LOS存在差异。国籍、婚姻状况、门诊诊断与出院诊断是否一致、入院诊断与出院诊断是否一致均无显著差异。住院次数、入院类型、出院类型、疾病严重程度类型、住院与出院科室协议、HAI、抗生素使用、医疗支付方式对LOS有显著预测作用,而其他因素对LOS无显著预测作用。入院与出院科室之间的协议对LOS的直接影响占总影响的86.88%。结论医院观察到影响LOS的因素,包括住院和出院部门之间的共识。建议应侧重于资源配置和决策优化,引导患者到合适的科室,同时改善其他关键因素。
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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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