某院2012~2014年155 508例住院患者疾病分布规律分析

Disease distribution of 155,508 inpatients of a hospital between 2012 and 2014

摘要:

目的  探讨怀化市第一人民医院2012～2014年155 508例住院患者疾病分布规律。方法  根据ICD-10分类标准，整理该院住院患者病案的主要诊断数据，运用描述性统计分析和秩和比（RSR）检验法分析疾病的构成和变化趋势，采用计算相关系数法分析每年月入院就诊人数趋势变化规律，采用χ2检验法对性别、年龄和转归情况进行总结。结果  ①该院每年月入院人数变化趋势一致（相关系数r ≥0.8）；②男女性别比从1.11∶1下降至1.06∶1；③60岁及以上住院患者最多，占总人数的32.03%；④患者治愈率逐渐增加（χ2= 35.842，P =0.000），死亡率逐渐降低（χ2=7.950，P =0.019）；⑤除城区外，下辖县为主要病源地，占总收治患者人数57.38%；⑥前5位系统疾病分别为呼吸系统疾病、循环系统疾病、肿瘤、消化系统疾病以及传染病和寄生虫病，经秩和比检验，3年内前10位疾病构成未发生明显变化（χ2=0.023，P =0.991）；⑦前5位单病种为：缺血性心脏病、肺炎、脑血管病、慢性支气管炎或肺气肿以及糖尿病，且与年龄有一定相关性。结论  常见的慢性疾病是该院的重点服务范围，应根据该院疾病分布特征，合理调配卫生资源。

Abstract:

Objective To investigate the distribution law of diseases among 155,508 inpatients from 2012 to 2014 in a hospital. Methods The related disease data were classified according to ICD-10 based on the first diagnosis. Descriptive statistics and rank-sum ratio (RSR) test were adopted to analyze the disease constitution and variation trends. Meanwhile, based on correlation coefficient method and Chi-square test, the variation trends of inpatients were illustrated, and the sex, age and clinical outcomes of the patients were summarized. Results The variation trends of monthly inpatients were similar (r > 0.8). The male to female ratio decreased from 1.11 : 1 in 2012 to 1.06 : 1 in 2014. The inpatients aged 60 or above accounted for 32.03%. The cure rate in the patients was gradually increasing (χ2 = 35.84, P = 0.000), and the fatality rate was descending (χ2 = 7.95, P = 0.019). The inpatients from the managed counties, townships, cities and villages in Huaihua accounted for 57.38%. The top 5 systemic diseases were respiratory diseases, circulatory diseases, tumors, digestive diseases, infectious and parasitic diseases. It was found that the disease constitution did not change significantly in the past 3 years through RSR test (χ2 = 0.023, P = 0.991). The top 5 single diseases (ischemic heart diseases, pneumonia, cerebral vascular diseases, chronic bronchitis/emphysema and diabetes) were related to the age. Conclusions Common chronic diseases are the principal service of the hospital. We should reasonably allocate and coordinate the health resources based on the features of disease distribution.