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利用医疗保健成本与利用项目(HCUP)数据库研究美国共病、疾病严重程度与住院时长之间的关系。

Relationships Among Comorbidities, Disease Severity, and Hospitalization Duration in the United States Using the Healthcare Cost and Utilization Project (HCUP) Database.

作者信息

Lee Junse, Park Jungmin

机构信息

School of AI Convergence, Sungshin Women's University, Seoul 02844, Republic of Korea.

College of Nursing, Hanyang University, Seoul 04769, Republic of Korea.

出版信息

J Clin Med. 2025 Jan 21;14(3):680. doi: 10.3390/jcm14030680.

Abstract

: Hospital length of stay (LOS) is widely analyzed and serves as a benchmark for assessing changes during hospitalization. This study introduced a method to estimate patients' LOS and highlighted the variations in LOS among individuals with or without multiple chronic conditions (MCCs) and across different levels of disease severity, using data from the 2016 National Inpatient Sample in the United States. : To analyze the factors influencing LOS, a multinomial logistic regression model was employed, demonstrating its effectiveness in estimating and predicting expected LOS. Factors such as demographic characteristics, MCCs, and disease severity were strongly linked to LOS. : The overall prevalence of MCCs exceeded 66%, rising to over 90% among elderly patients and more than 88% among those with severe diseases. LOS distribution was primarily concentrated within the first month following admission: over 13% of patients were discharged within a day, over 85% within a week, and more than 99% within a month. Multinomial logistic regression analysis showed that LOS was significantly influenced by age, disease severity, and the presence of MCCs. Older patients, especially those with MCCs, had significantly longer LOSs compared to younger patients without MCCs. : LOS tended to increase with age and higher disease severity, particularly in patients with MCCs. Multinomial logistic regression revealed that patients over 65 and those with high disease severity (severity score 4) had significantly longer LOS. Shorter LOS was more frequent among patients under 65 years old, those without MCC, and those with low disease severity, whereas longer LOS was commonly observed in patients with MCCs or high disease severity.

摘要

住院时长(LOS)受到广泛分析,并作为评估住院期间变化的一个基准。本研究引入了一种估计患者住院时长的方法,并利用美国2016年全国住院患者样本数据,突出了患有或未患有多种慢性病(MCC)的个体之间以及不同疾病严重程度水平下住院时长的差异。

为了分析影响住院时长的因素,采用了多项逻辑回归模型,证明了其在估计和预测预期住院时长方面的有效性。人口统计学特征、多种慢性病和疾病严重程度等因素与住院时长密切相关。

多种慢性病的总体患病率超过66%,老年患者中这一比例升至90%以上,重症患者中超过88%。住院时长分布主要集中在入院后的第一个月内:超过13%的患者在一天内出院,超过85%在一周内出院,超过99%在一个月内出院。多项逻辑回归分析表明,住院时长受年龄、疾病严重程度和是否患有多种慢性病的显著影响。与没有多种慢性病的年轻患者相比,老年患者,尤其是患有多种慢性病的老年患者,住院时长明显更长。

住院时长往往随着年龄增长和疾病严重程度的提高而增加,尤其是在患有多种慢性病的患者中。多项逻辑回归显示,65岁以上的患者和疾病严重程度高(严重程度评分为4)的患者住院时长明显更长。住院时长较短的情况在65岁以下、没有多种慢性病且疾病严重程度低的患者中更为常见,而住院时长较长的情况通常出现在患有多种慢性病或疾病严重程度高的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db4f/11818793/bf91216f846a/jcm-14-00680-g001.jpg

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