三级综合医院住院超30天患者的影响因素及医疗资源消耗分析

Analysis of Influencing Factors and Medical Resource Consumption of Inpatients with Hospitalization Duration Exceeding 30 Days in Tertiary General Hospitals

摘要: 目的：探讨导致患者住院时间超过30天的影响因素，并分析其医疗资源消耗特征，为医院优化资源配置、提升管理效率提供依据。方法：回顾性分析该院2023年至2025年共64,089例出院患者病历资料，其中住院 > 30天患者1142例(病例组)，≤30天患者62,947例(对照组)。采用χ²检验或t检验进行单因素分析，并将单因素分析中具有统计学意义的变量纳入多因素Logistic回归模型，分析其独立影响因素。结果：住院超30天患者占比1.78%。多因素Logistic回归分析显示，男性、住院次数 ≥ 3次、住院期间发生转科、总费用高是住院时间超过30天的独立危险因素(OR > 1, P < 0.05)。该人群平均住院日达49.35天，平均费用为99244.60元，日均费用为2277.79元。患者主要集中在肿瘤科、心脏血管外科、肾内科、神经外科和重症医学科(累计占比54.4%)。结论：住院超30天患者消耗了大量的医疗资源，其发生是多种因素共同作用的结果。医院应重点关注高频住院、病情复杂需转科治疗的患者，并对高负担科室进行临床路径优化和成本管控。

Abstract: Objective: Objective: To investigate the factors contributing to hospital stays exceeding 30 days and analyze their characteristics of medical resource consumption, providing a basis for hospitals to optimize resource allocation and improve management efficiency. Methods: A retrospective analysis was conducted on medical records of 64,089 discharged patients from the hospital between 2023 and 2025, including 1142 cases (case group) with hospital stays > 30 days and 62,947 cases (control group) with stays ≤ 30 days. Single-factor analyses were performed using χ²-test or t-test, and statistically significant variables were incorporated into a multivariate Logistic regression model to identify independent risk factors. Results: Patients with prolonged hospital stays accounted for 1.78% of the total. Multivariate Logistic regression analysis revealed that male gender, three or more hospitalizations, inpatient transfers, and higher total costs were independent risk factors (OR > 1, P < 0.05). This group had an average hospital stay duration of 49.35 days, with total costs averaging 99244.60 yuan (RMB) and daily expenses reaching 2277.79 yuan. The majority of patients were concentrated in oncology, cardiovascular surgery, nephrology, neurosurgery, and critical care medicine departments (collectively accounting for 54.4%). Conclusion: Extended hospital stays consume substantial medical resources, resulting from multiple interacting factors. Hospitals should prioritize high-frequency hospitalized patients requiring complex condition management through clinical pathway optimization and cost control in high-burden departments.