Methods From December 2015 to December 2016, a total of 3 421 cases of pregnant women who were delivered or treated in the First Affiliated Hospital of Xi′an Jiaotong University were selected as research subjects. Then the patients′ maternal age, nationality, times of hospitalization, and the clinical data of this pregnancy, such as length of hospital stay, payment methods of medical care costs, modes of delivery, the seasons of operation, operation levels, whether transferring from other department into maternity ward or not, pregnancy complications, fetal pregnancy outcomes and so on were collected by retrospective method. Idependent-samples t test and one-way ANOVA were used to compare the length of hospital stay of pregnant women between two groups and three groups, respectively. Multiple linear stepwise regression analysis was used to analyze the influence factors of length of hospital stay of pregnant women. The procedure in this study was in line with the requirements of the World Medical Association Declaration of Helsinki revised in 2013.
Results ①The length of hospital stay of 3 421 cases of pregnant women was (6.4±3.0) d. The maternal age was (29.5±3.9) years old, and the elderly women (≥ 35 years old) accounted for 11.0% (375/3 421). ②Univariate analysis of the factors influencing the length of hospital stay of pregnant women showed that there were significant differences in the length of hospital stay of pregnant women with different ages (<35 years old and ≥ 35 years old), different times of hospitalization (1 time and ≥2 times), and different payment methods of medical care costs (self-paying, new rural cooperative medical insurance, urban residents basic medical insurance, urban workers basic medical insurance), different delivery modes (spontaneous delivery, forceps delivery, caesarean section), different operation levels (therapeutic or without operation, first-level operation, second-level operation, third-level operation), whether transferring from other department into maternity ward or not, combined with pregnancy complications or not, and different fetal pregnancy outcomes (poor and good) of this pregnancy, and all the differences were statistically significant (t=-3.34, -2.24; F=15.46, 268.81, 259.68; t=-7.58, -13.57, -13.82; all P<0.05). ③Multiple linear stepwise regression analysis results showed that self-paying (β=0.08, 95%CI: 0.01-0.16, P=0.035) or new rural cooperative medical insurance (β=0.32, 95%CI: 0.06-0.59, P=0.018), spontaneous delivery (β=0.29, 95%CI: 0.04-0.54, P=0.026), therapeutic or without operation (β=0.95, 95%CI: 0.71-1.19, P<0.001) or first-level operation (β=-0.47, 95%CI: -0.79--0.15, P=0.004), ≥ 2 times of hospitalization (β=0.26, 95%CI: 0.01-0.51, P=0.043), pregnancy complications (β=0.76, 95%CI: 0.58-0.95, P<0.001), and transferring from other department into maternity ward (β=6.55, 95%CI: 4.32-8.77, P<0.001) of this pregnancy all were the influence factors of length of hospital stay in 3 421 cases of pregnant women.
Conclusions The length of hospital stay of pregnant women in Xi′an is influenced by payment methods of medical care costs, modes of delivery, operation levels, pregnancy complications, fetal pregnancy outcomes and transferring from other department into maternity ward and so on. In clinical, targeted measures should be taken to shorten the average length of hospital stay, also to relieve the burden on the hospital and improve the efficiency of the usage of medical resources.