Analysis of current situation of day surgery patients’ withdrawal from hospitalization_West China Medical Journal

Authors：

XIA Yan ¹ ,  YUAN Huadi ² , XIA Feng ¹ , ZHANG Xiulai ³

1. Medical Insurance Office, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P. R. China;
2. Nursing Department, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P. R. China;
3. Medical Affairs Department, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P. R. China;

Corresponding author：

YUAN Huadi, Email: yhd751024@zju.edu.cn

Keywords：

Day surgery; Withdrawal from hospitalization; Preoperative management

DOI：

10.7507/1002-0179.202012332

Video：

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Objective To analyze the current situation of day surgery patients’ withdrawal from hospitalization, and put forward reasonable and effective measures and suggestions.Methods Descriptive statistical analysis and trend chi-square test were conducted on the hospitalization withdrawal rate of day surgery in the Day Surgery Ward of the Second Affiliated Hospital Zhejiang University School of Medicine from 2012 to 2020. The reasons for hospitalization withdrawal and the operation methods of withdrawn cases from 2019 to 2020 were descriptively analyzed.Results From 2012 to 2020, the hospitalization withdrawal rate of day surgery decreased from 4.48% to 2.19%, with a significant decrease and a linear downward trend (χ²_trend=138.500, P<0.001). From 2019 to 2020, patient factor was the most important reason for hospitalization withdrawal of day surgery, accounting for 79.72%; secondly, long waiting time for surgery, abnormal examination results, inadequate preoperative evaluation, medical insurance reimbursement, epidemic situation in 2020 and other reasons had affected the patients’ hospitalization withdrawal of day surgery to varying degrees. Endoscopic lithotripsy accounted for the largest proportion (210 cases, accounting for 20.87%) in the withdrawn procedures from 2019 to 2020, followed by minimally invasive rotary resection for breast lesions (126 cases, accounting for 12.52%).Conclusion Improving preoperative evaluation, strengthening preoperative communication, implementing efficient medical treatment, and shortening the waiting time for surgery can reduce the rate of hospitalization withdrawal of day surgery.

Citation： XIA Yan, YUAN Huadi, XIA Feng, ZHANG Xiulai. Analysis of current situation of day surgery patients’ withdrawal from hospitalization. West China Medical Journal, 2021, 36(2): 211-214. doi: 10.7507/1002-0179.202012332 Copy

1.	杨玲, 黄小龙, 罗旭, 等. 国内外日间手术发展现状与思考. 中国卫生质量管理, 2020, 27(4): 33-37.
2.	俞德梁, 宁鹏涛, 王娟, 等. 关于日间手术定义与首批推荐适宜手术的思考. 医学与哲学, 2015, 36(24): 5-7, 14.
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5.	于丽华. 中国日间手术发展的历程与展望. 中国医院管理, 2016, 36(6): 16-18.
6.	傅文静, 李晓玲. 日间手术临时取消的现状及其干预的研究进展. 广西医学, 2020, 42(18): 2429-2432.
7.	徐嘉莹, 宋锴澄, 易杰, 等. 国外日间手术麻醉术前评估的新进展. 中国卫生质量管理, 2018, 25(4): 10-13.
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10.	廖文娟, 匡雪春, 刘军, 等. 三甲医院日间手术患者焦虑情况调查分析. 实用医院临床杂志, 2016, 13(3): 123-124.
11.	曹昕, 骆洪梅. 两种床位预约模式对眼科日间手术患者到达医院后取消手术的影响分析. 华西医学, 2016, 31(4): 629-631.
12.	蒋丽莎, 马洪升. 日间手术评价与监控指标初探. 华西医学, 2019, 34(2): 202-205.
13.	蒋丽莎, 谢晓兰, 戴燕, 等. 四川大学华西医院日间手术入院前管理规范. 华西医学, 2019, 34(2): 133-136.
14.	杨陈, 张学兵, 吴婷婷, 等. 评价某市儿童医院日间手术的效果. 中国病案, 2018, 19(9): 42-45.
15.	叶家慧. AIDET沟通模式对日间手术患者焦虑情绪及满意度的影响. 现代诊断与治疗, 2020, 31(9): 1505-1506.
16.	王建安. 后疫情时代的公立医院如何从“跑马圈地”转向“效率医疗”. 光明日报, 2020-08-23(6).
17.	汪雅璇. 基于平均住院日的我国医院资源优化配置研究. 天津: 天津医科大学, 2016.
18.	浙江省医疗保障局. 关于印发《浙江省省级及杭州市基本医疗保险住院费用DRGs点数付费实施细则（试行）》的通知. (2020-05-11)[2020-12-30]. http://ybj.zj.gov.cn/art/2020/5/11/art_1604513_42901498.html.

1. 杨玲, 黄小龙, 罗旭, 等. 国内外日间手术发展现状与思考. 中国卫生质量管理, 2020, 27(4): 33-37.
2. 俞德梁, 宁鹏涛, 王娟, 等. 关于日间手术定义与首批推荐适宜手术的思考. 医学与哲学, 2015, 36(24): 5-7, 14.
3. 白雪, 马洪升, 罗利. 中外日间手术发展对比研究及展望. 中国医院管理, 2014, 34(5): 35-37.
4. 余江, 周来新, 张云福, 等. 开展院前检查合理缩短术前平均住院日的做法. 中国医院管理, 2016, 36(10): 40-41.
5. 于丽华. 中国日间手术发展的历程与展望. 中国医院管理, 2016, 36(6): 16-18.
6. 傅文静, 李晓玲. 日间手术临时取消的现状及其干预的研究进展. 广西医学, 2020, 42(18): 2429-2432.
7. 徐嘉莹, 宋锴澄, 易杰, 等. 国外日间手术麻醉术前评估的新进展. 中国卫生质量管理, 2018, 25(4): 10-13.
8. Apfelbaum JL, Connis RT, Pasternak LR, et al. Practice advisory for preanesthesia evaluation: an updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology, 2012, 116(3): 522-538.
9. 吴莉萍, 奚凯雯, 余慧, 等. 困扰医护人员与患者参与日间手术现状问题的研究进展. 重庆医学, 2020, 49(20): 3481-3485.
10. 廖文娟, 匡雪春, 刘军, 等. 三甲医院日间手术患者焦虑情况调查分析. 实用医院临床杂志, 2016, 13(3): 123-124.
11. 曹昕, 骆洪梅. 两种床位预约模式对眼科日间手术患者到达医院后取消手术的影响分析. 华西医学, 2016, 31(4): 629-631.
12. 蒋丽莎, 马洪升. 日间手术评价与监控指标初探. 华西医学, 2019, 34(2): 202-205.
13. 蒋丽莎, 谢晓兰, 戴燕, 等. 四川大学华西医院日间手术入院前管理规范. 华西医学, 2019, 34(2): 133-136.
14. 杨陈, 张学兵, 吴婷婷, 等. 评价某市儿童医院日间手术的效果. 中国病案, 2018, 19(9): 42-45.
15. 叶家慧. AIDET沟通模式对日间手术患者焦虑情绪及满意度的影响. 现代诊断与治疗, 2020, 31(9): 1505-1506.
16. 王建安. 后疫情时代的公立医院如何从“跑马圈地”转向“效率医疗”. 光明日报, 2020-08-23(6).
17. 汪雅璇. 基于平均住院日的我国医院资源优化配置研究. 天津: 天津医科大学, 2016.
18. 浙江省医疗保障局. 关于印发《浙江省省级及杭州市基本医疗保险住院费用DRGs点数付费实施细则（试行）》的通知. (2020-05-11)[2020-12-30]. http://ybj.zj.gov.cn/art/2020/5/11/art_1604513_42901498.html.

West China Medical Journal

Analysis of current situation of day surgery patients’ withdrawal from hospitalization

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