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目的:分析国内三级医院住院患者死亡率的影响因素。方法:选取《中国二三级医院医疗服务能力》基线调查中三级医院具有完整的住院患者死亡率和人力资源等数据的医院进行统计分析。结果:国内三级医院总体住院患者死亡率的中位数为0.838%(0.485%!1.378%),北部地区的住院患者死亡率高于南部地区(P<0.001);多元线性回归分析结果显示医护比和住院ICU死亡率与住院患者死亡率正相关,每床出院患者数和每护士出院患者数与住院患者死亡率负相关;医生护士的职称和学历与住院患者死亡率没有关系。结论:国内南部和北部地区住院患者死亡率差异明显;加强ICU建设、增加护士人数、提高医护人员经验和技能也许可以降低住院患者死亡率。
Objective: To analyze the influencing factors of in-patient mortality in tertiary hospitals in China. Methods: To select the hospitals with complete data of in-patient mortality and human resources in tertiary hospitals in the baseline survey of “medical service capabilities of secondary and tertiary hospitals in China” for statistical analysis. Results: The median inpatient mortality rate was 0.838% (0.485%, 1.378%) in the tertiary hospitals in China, and the inpatient mortality rate in the northern areas was higher than that in the southern areas (P <0.001). Multivariate linear regression analysis showed that medical care It was positively correlated with in-hospital ICU mortality rate and in-hospital mortality rate. The number of discharged patients per bed and the number of discharged patients per nurse was negatively correlated with in-hospital mortality rate. The professional titles and educational qualifications of doctors and nurses were not related to in-patient mortality rate. Conclusions: There is obvious difference in the mortality rate of inpatients in the southern and northern parts of the country. Strengthening the construction of ICU, increasing the number of nurses and improving the medical staff experience and skills may reduce the inpatient mortality rate.