某區域醫院加護病房病人非計劃性重返現况評估

An Evaluation of Readmission to the ICU during a Single Hospital Admission at a Regional Hospital

廖浩欽(How-Chin Liao) ； 胡百敏(Bai-Min Hu) ； 樊美知(Mei-Chih Fan) ； 廖訓禎(Shiumn-Jen Liaw) ； 葉美枝(Mei-Chih Yeh) ； 金霍歌(Huo-Ko Chin)

《中華民國急救加護醫學會雜誌》 18卷2期 (2007/06) Pp. 52-60

https://doi.org/10.30018/JECCM.200706.0001

摘要

研究目的：本研究對病人於單次住院中重返加護病房之狀况進行評估及專職主治醫師介入之影響性。
方法：資料蒐集自民國91年9月至92年8月及93年1月至12月兩階段内加護病房病人之年龄、性别、進入時診斷、進入加護病房之24小時APACHE Ⅱ分数、加護病房留置時間等資料，以病歷回顧方式判斷病人重返加護病房之原因。
结果：研究期間之非計劃性重返率為9.75%, Logistic迴歸分析發现，年龄、性别、第一次加護病房留置時間及第一次進入加護病居之24小時APACHE Ⅱ分數與典非預期重返具有統計上的顯著相關，專職主治醫師之介入没有統計上的顯著差異。
结論：研究结果顯示不同醫院或不同狀况之加護病房之重返率不適於直接互相評比，應同時考慮個别醫院政策以及病人病情等相關因素。

關鍵字

加護病房 ； 重返率 ； 醫療品質指標

並列摘要

Study purpose: This study investigated the present situation with respect to readmission to the Intensive Care Unit (ICU) during a single hospital admission and whether this is influenced by the ICU doctors.
Method: The study period was from September 1, 2002 to August 31, 2003 and included all of 2003. Data collection included patient's age, sex, the ICU initial diagnosis, 24 hours' APACHE Ⅱ score and ICU length of stay (LOS). The reasons for readmission to the ICU were collected by chart review.
Results: The unexpected readmission rate was 9.75%. Age, sex, the first time ICU LOS and first time 24 hours' APACHE Ⅱ score showed a statistically significant correlation with ICU readmission using logistic regression analysis. The factors related to the doctor involved with the patient showed no significance.
Conclusion: The study result demonstrated that ICU readmission rate is not an appropriate independent indicator by which to compare different hospitals or ICUs. It is better to compare after adjusting for other factors, such as individual hospital policy and patient severity.

並列關鍵字

ICU ； readmission rate ； medical care quality indicator