| To promote the quality of hospital service, not only proper introduction of macro-policy and optimization of whole structure, but also quality management involved in all kinds of healthcare activities are needed so as to discover problems promptly and to eliminate mistakes and waste. For the purpose of discovering rules and problems existed in the process of consumption of healthcare service, we collected and analyzed the process information of cost, diagnosis and treatment, and diagnostic exams of inpatients during their hospitalization by means of Hospital Information System (HIS, network version). This study can provide foundations for continuous quality improvement of healthcare service.We analyzed the process information of medicine cost and diagnosis and treatment of 260 operation inpatients and 572 non-operation inpatients, and diagnostic exams of 3427 inpatients with SPSS and SPLM software. The contents and results are as follows:1. Regular pattern of daily medicine cost change of operation inpatients during hospitalizationOperation inpatients were divided into 15 groups according to ICD-9-CM. We analyzed the regular pattern of daily medicine cost change of operation inpatients during hospitalization in every group. The results indicated that the median line of daily medicine cost had similar regular pattern in operations on the nervous system, the musculoskeletal system, the nose, mouth, and pharynx system and the female genital organs system : the top of daily medicine cost median emerged on the day of operations; The median of daily medicine cost was low in the period after operation, and the lowest in the period before operation. The median line of daily medicine cost of operations on the digestive system and the integumentary system keeped ata high level in the period of 1-6 days after operations. The regular pattern of daily medicine cost change showed that medicine cost control should be emphasized on the medicine use in perioperative period.2. The analysis of applying antibioticThe most frequently used medicines were those for balancing water, electrolite, acid and alkalescence (28.8%) in the body, and followed by anti-infection (15.3%) and vitamin (9.8%). Of anti-infection medicines, the frequency of antibiotic application was the highest (79.0%). The frequency of the use of these medicines showed the principles of medicine application were fluid infusion, anti-infection and health support.In 260 operation inpatients, there were 63 inpatients applying anti-infection medicine (24.2%). The cost of anti-infection medicine accounted for 34.1% of total medicine costs. The frequency of applying Penicillin, Acillin and Cefamezin was quite high, representing more than 60% of all antibiotics. Obviously, they are the main medicines for infectious diseases. Although the expensive antibiotics were used only in a few inpatients (9.6%), their cost was higher. If expensive antibiotic application is unreasonable, it is certain to result in the rapid increase of medicine cost. The control should be emphasized on the following 2 points: expensive and valuable antibiotics were used too often for prophylactics, and the time of applying them was too long.3. Analysis of the situation and influencing factors of inefficient hospitalization days of operation inpatientsInefficient hospitalization days were prevalent in operation inpatients (incidence rate 64.7%), mainly distributing in the period of 1-4 days before operation. Stepwise regression analysis showed that the influencing factors on inefficient hospitalization days were fee type, hospitalization days before operation and length of stay. If the inefficient hospitalization days had been eliminated, average length of stay would be shortened by about 1.5 days.4. The distribution and regular pattern of daily medicine cost change of non-operation inpatients80% of daily medicine cost were less than 100 yuan, but the sum was just 16.3% of total medicine cost. 7.5% of daily medicine cost were more than 300 yuan, but the sum was 63.
|
PDF Full Text Request