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目的通过对某医院非医嘱离院病人相关因素进行分析,了解当地居民的医疗需求和该院医疗服务的提供情况,为医疗管理提供依据。方法通过Logistic回归分析2013年1月1日-2014年7月31日2779例非医嘱离院的相关因素,并对每个与其有关的变量进行分析,了解非医嘱离院的具体原因。结果非医嘱离院者自费比例为64.68%,平均年龄为56.63岁,住院期间抢救率为25.31%,均远高于医嘱离院者;非医嘱离院者住院天数中位数为4天,远低于医嘱离院患者;55.70%的非医嘱离院是患者病情危重,家属放弃治疗。结论医院应重视非医嘱离院群体,努力提高重危病人诊治能力和服务水平,加强医患沟通,从而减少非医嘱离院的发生并有效降低随之而来的负面影响。
Objective To analyze the related factors of outpatients in a hospital from non-doctor’s orders, understand the medical needs of local residents and provide medical services in the hospital, and provide the basis for medical management. Methods Logistic regression was used to analyze the related factors of 2,779 non-medical orders discharged from January 1, 2013 to July 31, 2014, and the analysis of each related variable to find out the specific reasons for the non-medical orders to go to hospital. Results The percentage of non-doctor-ordered expeditions at their own expense was 64.68%, with an average age of 56.63 years. The average rescue rate during hospitalization was 25.31%, much higher than that of doctors leaving the hospital. The median number of hospital days of non-doctor-ordered expatriates was 4 days. 55.70% of non-doctor’s orders were hospitalized patients in critical condition, family members to give up treatment. Conclusion The hospital should pay attention to the group of outpatients who are not doctor’s orders, strive to improve the diagnosis and treatment ability and service level of the critically ill patients, strengthen communication between doctors and patients so as to reduce the incidence of non-doctor’s orders and effectively reduce the negative impact.