Prognostic Comparisons of different time patients’ discharges from Intensive care units in Taipei municipal general hospitals

• Main Authors: Tsong-Mei Cheng, 鄭聰美
• Other Authors: Su-Chiu Chen
• Format: Others
• Language: zh-TW
• Published: 2002
• Online Access: http://ndltd.ncl.edu.tw/handle/63491484556074519090

碩士 === 國立台北護理學院 === 醫護管理研究所 === 91 === ABSTRACT Graduate School：Department of Health Management, National Taipei College of Nursing. Title：Prognostic Comparisons of different time patients’ discharges from Intensive care units in Taipei municipal general hospitals Advisor：Su-Chiu Chen Author：Tsong-Mei Cheng The increase of the life expectancy and chronic disease in human population has increased the demand of intensive care beds. Goldfrad and Rowan (2000) compared the mortality of the day and night time discharges in intensive care patients. They found that there was no statistical difference between the mortality of day and night time discharges after adjusting the planned discharges. Therefore, this research is to understand the practicability of planned night discharges by comparing the prognostics of various time discharges from patients in intensive care units. This research design was a retrospectively prospective study by abstracting patients’ medical charts, following up in intensive care units, and also linking national death files. Research population was patients hospitalized in medical intensive care units of Taipei municipal general hospitals from July 2000 to June 2001. A sample of 1,040 available patients were from four of the above hospitals that the consent letter was signed. Logistic regression analysis and survival statistical analysis were performed. The results showed that there was no statistical difference among three discharging times (08:00-11:59, 12:00-15:59, 16:00-07:59) for the morality (log-rank p = 0.1984) and readmission (log-rank p =0.8077). Only acute physiology Score (APS) in discharges showed a statistically significant difference among three discharging times, other variables such as age, gender, patients’ resources, APS in admission, and chronic diseases in 661 discharged patients in intensive care units were not. Moreover, there was no statistically significant difference among three discharging times form mortality and readmission after adjusting hospital, age, gender, patients’ resources, APS in admission, APS in discharge, and chronic diseases, length of stay (LOS) in intensive care unit, LOS in general ward. For policy discussion, it is suggested that planned patient’ discharges from intensive care unit can be extended to the time after official hour (16:00-20:00) in order to increases the flexible utilization of the intensive care beds.