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Analysis of medical act processes using data of a hospital information system

利用医院信息系统数据分析医疗行为流程

基本信息

批准号：
17590454
负责人：
OKUHARA Yoshiyasu
金额：
$ 1.02万
依托单位：
Kochi University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-17590454/
关键词：
hospital information system waiting time of outpatients reservation system for outpatients hospitalization medical process support in making clinical path 入院診療プロセス解析医療工程分析外来患者在院時間

项目摘要

We have investigated which factor affects in waiting time of the out patient with reservation by using the data extracted from a database of Integrated Medical Information System at Kochi University School of Medicine.As a result, we have found that the average consultation time of every physician and the balance of the number of patients in each reservation time frame have major influence. Based on the result, a method to decide the optimal number of patient for each reservation time frame by giving the average consultation time of each physician and total number of patient for every physician per day, time interval of a reservation time frame, the acceptable maximum waiting time have been devised.It has been shown by a simulation that the case by the optimal number of patients in each frame determined by this method could have shortened patients waiting time effectively.We also analyzed which medical acts were performed in high rate during a hospitalization for patients classified in … More to a DPC (Diagnosis Procedure Combination) category. We converted the dates in the data to relative dates from a basic date for each patient. Then the rates of medical acts performed on each relative day were calculated from all patients who belonged to the same DPC category.Among medical acts performed in high rate, laboratory examination results were compared between just after hospitalization and just before discharge. In the cases in which the relative ratios were significantly different from 1, we investigated whether those examinations could be used as indexes which show the degree of recovery.As a result, for surgical cases, the date of operation was the best date as the basic date compared with hospitalization date or discharge date. For internal medicine cases, hospitalization date was better than discharge date as the base date. In the case of laboratory examinations and radiography, the distributions of medical acts on each day showed many sharp peaks. They are considered as the dates on which scheduled medical acts were performed. On the other hand, broad and continuum peaks were found in the case of prescription and injections.In the comparison of laboratory examination results, we found that several kinds of examinations were statistically significant for surgical cases and could be used as the indexes of recovery. They were Total Bilirubin, CRP, Blood platelet and Creatinine kinase In the case of internal medicine, CRP and Lymphocyte were statistically significant.. Less

本研究使用高知大学医学部综合医疗信息系统的数据库，对预约门诊患者的候诊时间的影响因素进行了调查。结果发现，每位医师的平均诊疗时间和预约时间内的患者数的均衡性是影响预约门诊患者候诊时间的主要因素。基于该结果，通过给出每个医生的平均咨询时间和每个医生每天的患者总数、预约时间范围的时间间隔，仿真结果表明，用该方法确定的每帧最佳病人数，可以有效地缩短病人的等待时间。我们还分析了哪些医疗行为在住院期间的高频率分类的病人 ...更多信息 DPC（诊断程序组合）类别。我们将数据中的日期转换为每个患者的基本日期的相对日期。然后计算同一DPC类别的所有患者在每个相对日的医疗行为发生率，并对发生率高的医疗行为，比较入院后和出院前的实验室检查结果。在相对比值明显小于1的病例中，我们研究了这些检查是否可以作为反映恢复程度的指标。结果，对于外科病例，手术日期是与住院日期或出院日期相比的最佳基准日期。内科病例以住院日为基准日优于以出院日为基准日。在实验室检查和放射照相方面，每天的医疗行为分布呈现出多个尖峰。这些日期被视为进行预定医疗行为的日期。在实验室检查结果的比较中，我们发现几种检查对外科病例有统计学意义，可以作为恢复的指标。内科病例中，CRP、淋巴细胞计数与总胆红素、CRP、血小板、肌酸激酶有统计学意义。少