某區域醫院十四天內非計劃性再入院原因初探

Exploring the Causes of Unplanned Readmission within Fourteen Days Discharge

李金霏(Jin-Fei Lee) ； 宋淑英(Su-Ying Song) ； 湯蔭蘭(Yin-Lan Tang) ； 吳筱芸(Hsiau-Yun Wu)

《寶建醫護與管理雜誌》 8卷1期 (2010/06) Pp. 8-15

https://doi.org/10.29681/PCJHM.201006.0003

摘要

十四天內非計劃性再住院率是住院醫療照護品質之重要指標，本研究探討該指標個案現況，採病歷回溯性的方式，針對某區域醫院自97年1月1日至97年12月31日期間，共收集有效樣本87位進行統計分析。結果發現男、女比例為54：33，平均年齡為65.02歲，再度入院方式從急診住院者佔70.1%、由門診住院佔29.9%；以內科73.6%居多，其次為外科病例21.8%；分析原因發現，病情惡化佔多數43.7%，其次為癌症末期13.8%。診斷群組分析依序為消化系統疾病（29.9%）、泌尿道生殖系統疾病（17.2%）、腫瘤（17.2%）最為常見。部份再入院個案無法避免，但某部份可預防、可避免之病例，應強化機構內醫療團隊間聯合診治機制與出院準備服務品質，以及發揮衛教指導效益，提昇病患對疾病之認知與自我照顧能力，進而有效改善個案非計劃性十四天再入院之情形。

關鍵字

非計劃性再入院 ； 十四天內 ； 出院準備服務 ； 衛教指導

並列摘要

The unplanned readmission within fourteen days after discharge is one of the major quality indicators for inpatient service. This is a retrospective study that collected all relevant cases of the focal hospital to explore the causes of the unplanned readmission early. Material in this research is 87 cases who re-admitted to the inpatient department during the period of January 1st to December 31st of 2008. The result shows 54% are male and 36% female with average age at 65.02 years old. 70.1% of the cases were readmitted by way of emergency department, and 29.9% were transferred from the outpatient department. Most cases were from an internal medicine department with 73.6% of entire objects, whereas 21.8% from the surgery department. Main diagnoses of admitting these patients were worsening a condition at 43.7%, cancer at final stage at 13.8%. Patients were suffered with the digestive system at 29.9%, the urinary tract reproductive system at 17.2%, oncology at 17.2% is the top three diseases. Despite that some cases were inevitable, proper measures could be taken to avoid or prevent the occurrence of readmission, such as the inter-departmental cooperation consultation or discharge preparation, a comprehensive healthcare education on discharge. In the other hand, the problem of readmission early could be effectively improved by strengthen the patients self-care knowledge and capability.

並列關鍵字

Unplanned readmission early ； discharge preparation ； health education