اقامت غیر ضروری بیماران در بیمارستان‌های ایران: مرور نظام مند و متاآنالیز

نوع مقاله: مقاله پژوهشی

نویسندگان

1 گروه علوم مدیریت و اقتصاد بهداشت دانشگاه علوم پزشکی تهران

2 استادیار گروه مدیریت و اقتصاد بهداشت.گروه مدیریت و اقتصاد بهداشت، دانشکده بهداشت، دانشگاه علوم پزشکی زابل، زابل، ایران.

10.22118/jsmj.2019.148221.1457

چکیده

زمینه و هدف: کاهش مدت اقامت نامناسب بیماران در بیمارستان‌ها موجب ارتقای کارایی بیمارستان‌ها می‌شود. هدف این پژوهش شناسایی متوسط اقامت نامناسب بیماران در بیمارستان‌های کشور و عوامل مؤثر بر آن بوده است.
روش کار: برای انجام این پژوهش مروری منظم، کلیه مقالات مرتبط با سنجش متوسط اقامت نامناسب بیمار در بیمارستان‌های ایران منتشر شده در بازه زمانی (۱۳۸۵-۱۳۹۶) در ۸ پایگاه داده‌ای جستجو، جمع‌آوری و ارزیابی کیفیتی شدند. در نهایت، تعداد ۱۳ مقاله با استفاده از نرم افزارComprehensive Meta-Analysis تحلیل شدند.
نتایج: در این مطالعه، میزان بروز متوسط اقامت نامناسب در بیمارستان‌های ایران ۵.۴ درصد (۱۱.۴-۲.۴درصد: حدود اطمینان 95%) به دست آمد. بیشترین میزان متوسط اقامت نامناسب بیماران در تهران در سال ۱۳۹۴ با ۴۹.۰ درصد ۶۲.۵-۳۵.۷ درصد: حدود اطمینان۹۵%) و کمترین میزان متوسط اقامت نامناسب بیماران در شیراز در سال ۱۳۸۹ با ۰.۵ درصد (۱.۱-۰.۲درصد: حدود اطمینان۹۵%) به دست آمد. عوامل مربوط به بیمار، پزشک و بیمارستان منجر به بروز متوسط مدت اقامت نامناسب بیماران در بیمارستان شده است. متوسط اقامت نامناسب به ترتیب منجر به افزایش هزینه، افزایش زمان انتظار سایر بیماران و کاهش کیفیت خدمات شده بود. مهم‌ترین راهکارهای کاهش مدت اقامت نامناسب، اصلاح نظام بیمه و شیوه پرداخت، گسترش خدمات سرپایی و اصلاح عملکرد سیستم ارجاع بیماران بود.
نتیجه گیری: میزان متوسط اقامت نامناسب بیماران در بیمارستان‌های ایران تقریباً بالا است. بنابراین، سیاستگذاران و مدیران نظام سلامت باید اقدامات جدی به منظور کاهش میزان بروز متوسط اقامت نامناسب در بیمارستان‌ها بکار گیرند.
واژگان کلیدی: متوسط اقامت نامناسب، مرور نظام مند، متاآنالیز، بیمارستان، ایران

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