| 张微微,陆小伟,许伟,等.基于真实世界数据的老年肺部感染专病质量控制指标体系构建及验证的研究[J].中国临床保健杂志,2026,(1):105-109. |
| 基于真实世界数据的老年肺部感染专病质量控制指标体系构建及验证的研究 |
| Construction and validation of a quality control indicator system for pulmonary infection in the elderly based on real-world data |
| 投稿时间：2025-12-17 |
| DOI：10.3969/J.issn.1672-6790.2026.01.018 |
| 中文关键词: 肺疾病 质量控制 影响因素分析 老年人 |
| 英文关键词: Lung diseases Quality control Root cause analysis Aged Fund programs:Jiangsu Provincial Science and Education Capacity Improvement Project |
| 基金项目:江苏省科教能力提升工程项目 |
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| 中文摘要: |
| 目的 构建契合老年医学专业特色的老年肺部感染专病质量控制(简称 “专病质控”)指标体系,基于真实世界数据验证其应用价值,明确影响诊疗质量与效率的关键因素。方法 通过文献回顾、政策衔接与专家共识,初步构建“结构-过程-结果”三维老年肺部感染专病质控指标体系；依托江苏省老年医学医疗质量控制中心建立信息化数据平台,收集 2023年7月至2025年6月3 000例老年肺部感染病例的有效数据,采用多变量回归模型分析医疗效率、费用趋势、地区差异及患者预后的影响因素。结果 构建的指标体系可有效监测诊疗全过程,全省老年肺部感染患者平均住院日呈下降趋势,西药费用受集采政策影响显著降低；多变量回归分析显示,未行吞咽康复(OR=12.98)、血清白蛋白(OR=0.88)及CURB-65评分(OR=2.76)是影响患者转归与医疗资源消耗的核心因素(均P＜0.05)。结论 针对老年肺部感染初步建立“标准制订-培训推广-数据监测-反馈改进”的老年医学专病质控闭环路径,可为老年肺部感染诊疗质量提升提供有效的质量管理工具。 |
| 英文摘要: |
| Objective To establish a disease-specific quality control indicator system tailored to the characteristics of geriatric medicine for elderly patients with pulmonary infection,validate its application value using real-world data,and identify key factors influencing diagnosis and treatment quality and efficiency.Methods A preliminary three-dimensional quality control indicator system (structure-process-outcome) for pulmonary infection in the elderly was constructed through literature review,policy alignment,and expert consensus.An information-based data platform was established under the Jiangsu Provincial Quality Control Center for Geriatric Medicine,collecting data from 3 000 valid cases of geriatric pulmonary infection from July 2023 to June 2025.Multivariate regression model was used to analyze factors affecting medical efficiency,medical cost trends,regional disparities,and patient outcomes.Results The constructed indicator system effectively monitored the entire diagnosis and treatment process.The average length of stay (LOS) for elderly patients with pulmonary infection in the province showed a declining trend,and Western medicine costs decreased significantly due to centralized procurement policies.Multivariate regression analysis revealed that no swallowing rehabilitation (OR=12.98),serum albumin (OR=0.88),and CURB-65 score (OR=2.76) were core factors influencing patient outcomes and medical resource consumption (all P＜0.05).Conclusions A closed-loop quality control pathway for geriatric diseases was preliminarily established,encompassing "standard formulation-training promotion-data monitoring-feedback improvement" which can provide an effective quality-management tool for improving the quality of care for pulmonary infection in the elderly. |
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