某醫學中心出院後病人非計畫性14天內再住院之流行病學特徵調查

The Epidemiological Characteristics of Unplanned Readmission within 14 Days after Discharge from a Medical Center

本研究目的乃探討病人出院後非計畫性再住院之相關特徵，（1）非計畫性14天內再住院比率，（2）各季節變化再住院比率趨勢，（3）再住院原因排序前三位，（4）前次住院科別排序前三位。研究方法採橫斷性流行病學調查，研究對象為南部某醫學中心民國100年出院病人中非計畫性14天內再住院者，共1,085人次。研究變項有前次住院之科別、出院日期及本次住院日期、本次住院原因。研究資料由資訊室提供，資料分析以次數及百分比呈現各變項分佈。結果顯示，該醫學中心民國100年非計畫性14天內再住院年比率為2.37%。各季節變化再住院比率，分別為2.54%、2.38%、2.23%及2.37%，呈現略為平穩地下降趨勢。再住院原因排序前三位為疾病再復發佔36.53%、不明原因發燒佔9.60%及肺部感染佔7.92%。前次住院科別排序前三位為胸腔內科、一般內科、胃腸肝膽科。期待本結果提供醫院管理者擬定改善方案參考，以降低非計畫性14天內再住院比率及增加住院病人之品質。

The purposes of this study were to explore the epidemiological characteristics of patients who underwent unplanned readmission within 14 days after being discharged. The focal characteristics were as followings; (1) readmission rate, (2) seasonal variations in the readmission rate, (3) top three of causes of readmission, and (4) top three hospital units during previous hospitalization. A cross-sectional epidemiological survey was carried out. A total of 1,085 patients were recruited based on the following criterion of having been readmitted within 14 days after being discharged in 2011. The study variables included in which hospital unit the patient stayed during their previous hospitalization, the related discharge date, and cause of readmission. Data on these were collected from the hospital's Information Management Office. The data was analyzed by both frequency and percentage. The result showed that readmission rate of the medical center was 2.37% in 2011. The seasonal variations in the readmission rate showed a steady decrease, with figures of 2.54%, 2.38%, 2.23% and 2.37% for spring, summer, fall and winter, respectively. In addition, the top three of causes of readmission were as follows: hospitalization with the same diagnoses (36.53%), fever of unknown origin (9.60%), and pulmonary infection (7.92%). Finally, the top three units of previous hospitalization were chest medicine, general medicine and hepatobiliary gastroenterology. The results of this research could serve as a reference for hospital managers as they work to decrease readmission rates and improve the quality of care for hospitalized patients.