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目的调查2010年江西省永新县芦溪乡镇卫生院住院疾病构成及费用情况,了解当地疾病负担,为进一步研究提供基线数据。方法收集2010年该院住院病例资料,根据国际疾病分类编码(ICD-10)对出院记录的第一诊断进行疾病标化和系统归类,运用EXCEL 2003和SPSS 13.0等统计软件整理分析住院患者一般情况,出院诊断、医疗费用及使用基本药物情况等。结果①2010年芦溪乡院住院病例925人次,男女性别比为0.8;②住院系统疾病可分为17类,占ICD-10标准分类的81%;③前5类疾病依次为呼吸、消化、损伤中毒和外因、循环及泌尿生殖系统疾患,累计占82.27%;④前15位单病种依次为上呼吸道感染、骨折、慢性阻塞性肺病、慢性胃肠炎、脑血管病、泌尿系结石、类风湿性关节炎、椎间盘疾患、胆囊结石伴胆囊炎、心脏病、生殖器官疾病、损伤和中毒、肺炎、高血压及消化性溃疡;⑤上呼吸道感染和肺炎患者年龄均主要集中于≥65岁和<5岁;除了泌尿系结石和消化性溃疡外,其余8种慢性病患者的年龄均主要集中在≥65岁;⑥前15种单病种中,慢性病患者平均住院日及次均住院费用低于急性病(4.8天vs.11.6天;439.1元vs.666.9元);⑦芦溪乡镇卫生院住院费用虽逐年增加,但仍远低于全国乡院平均水平(542.3元vs.1 004.6元)。结论①2010年芦溪乡镇卫生院住院病例前3位系统疾病是呼吸、消化及损伤和中毒,其中前2种系统疾病均为女性多于男性;急性病多集中于感染和骨折。②前15位单病种中除类风湿性关节炎、胆囊结石伴胆囊炎、心脏病、生殖器官疾病和消化性溃疡外,其余10种单病种与四川永安乡院基本相同。③呼吸系统、损伤和中毒以急性病为主;消化、循环、泌尿生殖及肌肉骨骼和结缔组织系统以慢性病为主。④急慢性病在35岁以后年龄段患者呈显著增加趋势,且女性多于男性;≤15岁和≥35岁急性病患者的疾病负担均较重。⑤上呼吸道感染和肺炎患者均主要集中于老年人和儿童。⑥与甘肃新添乡院(基本型)相比,芦溪乡院骨折患者平均住院日长(43.7天vs.9天),次均住院费用高(1 948.0元vs.1 646.3元),疾病负担重(8.11%vs.4.85%)。⑦急性病患者平均住院日远高于四川永安(小康型)和甘肃新添(基本型)乡院(11.6天vs.3.7天、6.2天),但次均住院费用却远低于两院(666.9天vs.850.4元、906.85元)。
Objective To investigate the constitution and cost of hospitalized diseases in Luxi Township Health Center of Yongxin County, Jiangxi Province in 2010, to understand the local disease burden and to provide baseline data for further research. Methods The data of inpatients in this hospital in 2010 were collected. According to the International Classification of Diseases Code (ICD-10), the first diagnosis of discharge records was standardized and classified systematically. Statistical analysis of hospitalized patients by EXCEL 2003 and SPSS 13.0 Condition, discharge diagnosis, medical expenses and the use of essential medicines. Results ① There were 925 hospitalized cases in Luxi Township Hospital in 2010, with a sex ratio of 0.8; ② In-hospital system diseases were classified into 17 categories, accounting for 81% of the ICD-10 standard classification. ③ The top 5 diseases were respiratory, digestive, and injury Poisoning and external causes, circulatory and urogenital diseases, accounting for 82.27%; ④ The top 15 single diseases followed by upper respiratory tract infection, fractures, chronic obstructive pulmonary disease, chronic gastroenteritis, cerebrovascular disease, urinary calculi, Rheumatoid arthritis, disc disease, gallstones with cholecystitis, heart disease, genital diseases, injury and poisoning, pneumonia, hypertension and peptic ulcer; ⑤ patients with upper respiratory tract infection and pneumonia are mainly concentrated in patients aged ≥65 years and <5 years old; except urolithiasis and peptic ulcer, the other 8 chronic diseases were mainly aged ≥65 years old; ⑥ Among the top 15 single diseases, the average length of stay and the average hospitalization cost of chronic diseases were lower than Acute diseases (4.8 days vs.11.6 days; 439.1 yuan vs.666.9 yuan); ⑦ Luoxi township hospital although the annual increase in hospitalization costs, but still far below the average rural homes (542.3 yuan vs.1 004.6 yuan). Conclusion ① In 2010, the first three systemic diseases in Luoxi Township Hospital were respiratory, digestive, injury and poisoning, of which the first two kinds of systemic diseases were more women than men; the acute diseases were mostly concentrated in infections and fractures. ② The top 15 single disease except rheumatoid arthritis, gallstones with cholecystitis, heart disease, genital diseases and peptic ulcer, the other 10 kinds of single disease and Sichuan Yongan homes are basically the same. ③ respiratory system, injury and poisoning mainly acute; digestive, circulatory, genitourinary and musculoskeletal and connective tissue systems to chronic diseases. ④ acute and chronic diseases in the age group after 35 years of age was significantly increased trend, and more women than men; ≤ 15 years old and ≥ 35 years old patients with acute diseases are heavier burden of disease. ⑤ patients with upper respiratory tract infection and pneumonia are mainly concentrated in the elderly and children. (6) Compared with Xintian Township Hospital in Gansu (basic type), the average length of hospital stay in Luxi Township hospital was 43.7 days vs.9 days, the average hospitalization cost was high (1,948.0 yuan vs.1,646.3 yuan), disease Heavy burden (8.11% vs.4.85%). ⑦ The average length of stay in acute patients is much higher than those in Yongan of Sichuan (well-to-do type) and Xintian (basic type) in Gansu Province (11.6 days vs.3.7 days and 6.2 days) Day vs.850.4 yuan, 906.85 yuan).