住院病例組合複雜性與出院狀況及住院日數間之相關性探討－以大臺北都會區六家醫院為例

The purposes of this study are to examine whether the variations of hospitals' characteristics, admission departments, and in-patients' characteristics are different on in-patients case mix complexities; and to explore the relationships among case mix complexities, discharge status, and length of stay among in-patients of six hospitals in the Taipei Metropolitan Area. This cross-sectional study is evaluated by face-to-face interviewing 5992 in-patients from the six hospitals in the Taipei Metropolitan Area since November, year 2002. The six hospitals include two public local teaching hospitals, two private local nonteaching hospitals, and two public regional teaching hospitals. The independent variables in case mix complexities are functional status (for measuring physical and mental health, social and role functioning, and other general health concepts), severity of illness (staging of disease is the measurement scales of this study), co-morbidity numbers and its scales levels. The results support that there are significant differences among the six different hospitals in case mix complexities. Differences of the characteristics of hospitals (public/private, degree of hospital accreditation) lead to various case mix complexities. In discharge status and the length of stay, there are significant differences among admitted patient conditions, admission departments, the characteristics of the hospitals, and case mix complexities. The higher the case mix complexity, the longer the length of stay. Future research might focus on longitudinal study to explore the relationship among discharge status, resources consumption, multiple dimensions of evaluation, expanded sample hospitals and design appropriate evaluation instruments.