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題名 | 臺北榮民總醫院家庭醫學科病房五年住院病患分析=A Five-Year Survey of the Inpatient Service of the Department of Family Medicine in VGH-Taipei |
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作者 | 林明慧; 賴志冠; 陳曾基; 吳彬源; 蔡世滋; | 書刊名 | 中華民國家庭醫學雜誌 |
卷期 | 8:2 1998.06[民87.06] |
頁次 | 頁47-55 |
分類號 | 419.39 |
關鍵詞 | 家庭醫學科; 病房; 住院病患; Inpatients family practice; |
語文 | 中文(Chinese) |
中文摘要 | 臺北榮民總醫院自 1992 年 10 月起設置庭醫學科病房,至 1997 年 12 月底止 ,總住院病患共 1,402 人次。 為了解本院家庭醫學科病房收住病患狀況,本研究採回溯方 式,依據出院病患歷電腦資料檔及病患「出院病歷摘要」檔案記錄進行統計分析,並依國際 疾病分類系統( ICD-9-CM )登錄診斷資料。 研究結果顯示, 住院病患以男性佔數多數( 74.8% ),平均年齡為 63.24 歲(標準差 15.37 ),住院病患主要經由本科門診轉介入院 。平均住院天數為 14.40 天(標準差 14.25 ),住院期間病患轉科比例佔 10.1%,轉科理 由多因病情需要作進一步治療(如外科手術、心導管手術等)。出院狀況為「轉院」之病患 ,平均住院天數( 44.71 天)明顯高於其他各組( p<0.05 )。 出院狀況為「轉科」之病 患其平均住院天數( 27.96 天)與其它各組相較亦明顯偏高( p<0.05 )。約32.52% 病患 入院時有至少一個常見「未確定診斷」, 76.31% 在住院期間獲得確定診斷並接受進一步治 療及轉介。平均出院診斷數為 3.38 個(標準差 1.81 ),出院診斷數為一個或二個之病患 組,其平均年齡及平均住院天數雖少於其他組別,但未有統計學上之意義。本科病房住院病 患年齡層較高,以罹患內科疾患為主。 約 62% 病患出院診斷數大於三個以上,若不計轉科 及轉院病患,本科病房住院病患平均住院日數短於全院平均住院日數。醫學中心家庭醫學科 病房肩負教學訓練、轉診後續照顧及研究等多重責任。建議除應前瞻性例行記錄病房轉診、 照會之科別及原因,以補家庭醫學之不足,並宜建立常態性之品質稽核指標,嘗試建構常見 疾病及未分化症狀之臨床路徑,俾提昇家庭醫學科病房之照護品質並兼顧達成教育訓練之目 標。 |
英文摘要 | Starting in Oct. 1992, the Department of Family Medicine, Veterans General Hospital-Taipei had set up its inpatient wards. The total number of inpatient admissions reached 1,402 as of Dec. 1997. For further understanding of the content of inpatient service, we herein report a retrospective study based on the computer files of patient data and discharge summaries. Diagnoses are recorded with reference to the ICD-9-CM system, an international disease classification system. The results reveal that the majority of inpatients are males (74.8%) with a mean age of 63.24 years (SD 15.37, range from 10 to 98 years old). Most of the patients are transferred from the outpatient clinic of the Department. The average length of stay is 14.40 days (SD 14.25). Among the subgroups of patients, those who are transferred to other hospital for long-term care have a statistically significantly higher length of stay (44.71 days, SD 39.98) than the other groups (p<0.05). The mean length of stay in family practice wards for those who are transferred to other services is 27.96 (SD 22.38) days, also significantly higher than those who discharged on a stationary condition (p<0.05). During the hospitalization, about one-tenth (10.1%) of the patients are transferred to other services, mostly due to a need of treatment. (e.g., surgery or cardiac catheterization) About 32.52% of the patients have a common diagnosis of uncertain nature on admission. Nonetheless, 76.31% of them acquire a further confirmation of the disease, therapy, or appropriate transfer. The most common discharge diagnoses belong to internal-medicine ailments. Patients with discharge diagnoses made by other services or psychiatric problems are quite few. The characters of our inpatient service mostly offer the service to aged patients with internal-medicine ailments. They are discharged with multiple diagnoses. They stay in the hospital shorter than the average not including those who are transferred to other services or hospitals. It is suggested that to establish a quality improvement indicators in regard to the classification of diagnostic entities, handling the patients including making consultation, referring or transferring the patients to specialists. So that, the family medicine department in a medical center will not only promote the quality care, but also fulfill its goals of education and training. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。