진료의뢰센터 운영이 전원환자의 재원일수에 미치는 영향 - 일개 3차 의료기관 진료의뢰센터 경유 환자를 중심으로 -

The effect of operating the referral center on the Length of stay of transferred inpatients in a tertiary medical center

To compare differences of LOS between the group of inpatients via referral centers(the referral group) and the group of inpatients via different routes (the general group) and analyze factors which determine the difference. The 9,484 cases of newly inpatients of Mar., Jun., Sep., Dec. of year 2003 were used for the data. We calculate the Case-mix index of length of stay($CMI_{LOS}$) to compare LOS adjusted with the disease as the ratio of a patient' LOS to all patients' average LOS by 21 classification diagnosis group. We conducted t-test to compare differences of $CMI_{LOS}$ between two groups and multiple regression to analyze factors determining the difference. $CMI_{LOS}$ was 0.94 in the referral group, which was smaller than 1.01 in the general group. LOS was 7.5days in the referral group, which was 0.6day shorter than that in the general group. Multiple regression also showed that $CMI_{LOS}$ was smaller in the referral group than in the general group after controlling patients' general characteristics, diagnostic information variables. The referral centers can be said to playa role in decreasing LOS. We suggest that variety of depth studies on referral centers should be continued at the strategic level of hospital management using additional medical informations.