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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >The timing of neonatal discharge: An example of unwarranted variation?
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The timing of neonatal discharge: An example of unwarranted variation?

机译：新生儿出院的时间：不必要的变化的一个例子吗？

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摘要

Discharge from an intensive care nursery should be dependent on the infant's clinical and social condition and independent of the day of the week. OBJECTIVE: To evaluate admission and discharge dates of 5272 neonates cared for in 5 major metropolitan regions in the United States and managed by a national disease management company for the distribution of the day of the week. STUDY DESIGN: All infants discharged to home between July 1, 1996 and September 30, 1998 are included. Data are represented as a percentage of total discharges or admissions for each weekday assignment. Using the normal approximation to the multinomial distribution, we tested for proportional differences on each weekday. RESULTS: The data demonstrate that the timing of nursery discharge has an uneven distribution across the days of the week, with weekend (Saturday and Sunday) discharge rates that are significantly lower than weekday discharge rates. This uneven distribution exists in both the term and preterm subgroups as well. There is also an uneven distribution of births among the days of the week, with a pattern that reveals fewer weekend births than weekday births in the entire population studied, as well as in both the term and preterm subgroups. Normalizing these weekend discharges to the previous weekday could generate potential saving of Dollars 1 569 405 in charges for the total population and 627 days of hospitalization. The average length of stay of infants discharged on Mondays is longer than for those infants discharged on Saturday or Sunday. CONCLUSIONS: We speculate that changes in discharge planning could decrease the variation in day of discharge, shorten length of hospitalization, and potentially reduce cost.
机译：重症监护托儿所的出院应取决于婴儿的临床和社会状况，并且应与一周中的一天无关。目的：评估在美国5个主要大都市地区照管的5272例新生儿的入院和出院日期，并由一家国家疾病管理公司管理在一周中的一天中的分布。研究设计：包括1996年7月1日至1998年9月30日期间出院的所有婴儿。数据表示为每个工作日作业的总排放量或入场量的百分比。使用多项式分布的正态近似，我们测试了每个工作日的比例差异。结果：数据表明，托儿所的出院时间在一周的各天中分布不均，而周末（周六和周日）的出院率明显低于工作日的出院率。在学期和早产亚组中也存在这种不均匀分布。一周中各天的出生分布也不均匀，在整个研究人群中，无论是足月和早产亚组，显示出周末出生的人数都少于工作日出生的人数。将这些周末的出院时间恢复到上一个​​工作日的费用，可以为总人口和627天的住院治疗节省1 569 405美元。星期一出院的婴儿的平均住院时间长于星期六或星期日出院的婴儿。结论：我们推测出院计划的改变可以减少出院日的变化，缩短住院时间，并有可能降低成本。

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