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目的调查宁夏自治区吴忠市高闸镇中心卫生院2008～2010年度住院疾病构成及费用情况,为进一步研究提供基线数据。方法采取问卷调查结合专题访谈,收集该院2008、2009年及2010年(1月至11月)住院病例资料,按国际疾病分类(ICD-10)标准对出院记录的第一诊断进行分类,并分析其费用,包括住院患者一般信息、出院诊断名、住院费用、所用药品金额等,应用Excel软件整理数据和统计分析。结果①该院2008、2009、2010年度住院病例分别为1124、642、747人次,2008、2009年女性均多于男性(59.34%vs.40.66%,60.75%vs.39.25%),住院病例疾病谱分为17类,占ICD-10标准分类的81%。②近3年前6位系统疾病分别是呼吸系统、消化系统、循环系统、泌尿生殖系统、损伤与中毒、肌肉骨骼系统和结缔组织疾患,构成比86.63%～92.06%。除损伤与中毒外,其余5位系统疾患的住院病人均为女性多于男性。③近3年前15位单病种包括:肺部感染、气管/支气管炎、冠心病、软组织损伤、胃炎/慢性胃炎、上呼吸道感染、高血压、泌尿道感染、腰椎间盘突出、盆腔炎、骨折、肺心病、浅表外伤、慢性胆囊炎、关节炎。④2008、2009年住院病例主要疾病负担集中在35～54岁年龄段,其次为55岁及以上年龄段;除损伤与中毒外,多以女性居多。肺部感染集中在35岁后;高血压增加趋势明显,2008年在45～54岁年龄段较多,2009年在35～44岁年龄段多见。⑤近3年前15位单病种患者构成达64.06%～71.21%,含8～9种慢性病,且2010年排位靠前。急性病有6～7种,集中于感染和损伤。⑥2010年慢性病的各项平均费用均高于急性病。结论①高闸中心卫生院为西部全科型示范乡院,无论所处地区经济水平、住院疾病负担和费用情况等都与西部小康型示范乡院双流永安中心卫生院差距较大。②近3年主要的系统疾患是呼吸系统、循环系统和消化系统疾患,慢性病较多且有年轻化趋势;急性病集中于感染和损伤,肺部感染居近3年首位。③2008、2009年住院病例主要集中在35～54岁,其次为55岁及以上年龄段;除损伤与中毒外,多数以女性居多。④2010年慢性病住院患者人均住院费和人次均药费低于永安中心卫生院,应考虑住院费用构成的合理性。⑤该院信息基础工作和基础设施建设亟待加强与完善。
Objective To investigate the composition and cost of hospitalized diseases in Gaozha Town Central Hospital of Wuzhong City, Ningxia Autonomous Region from 2008 to 2010, and to provide baseline data for further research. Methods A questionnaire survey and interviews were conducted to collect inpatient data of the hospital in 2008, 2009 and 2010 (January to November), and to classify the first diagnosis of discharge records according to the International Classification of Diseases (ICD-10) Analysis of its costs, including general information of inpatients, diagnosis name of discharge, hospitalization costs, the amount of drugs used, the use of Excel software to organize data and statistical analysis. Results ① The hospitalized cases were 1124,642,747 in 2008, 2009 and 2010 respectively. Compared with males in 2008 and 2009 (59.34% vs.40.66%, 60.75% vs.39.25%), inpatient disease spectrum Divided into 17 categories, accounting for 81% of the ICD-10 standard classification. (2) The six systemic diseases in recent 3 years were respiratory system, digestive system, circulatory system, urogenital system, injury and poisoning, musculoskeletal system and connective tissue diseases, with the ratio of 86.63% to 92.06%. In addition to injury and poisoning, the remaining five patients with systemic diseases are more female than male. ③ The last 15 years alone included 15 single diseases including pulmonary infection, trachea / bronchitis, coronary heart disease, soft tissue injury, gastritis / chronic gastritis, upper respiratory tract infection, hypertension, urinary tract infection, lumbar disc herniation, pelvic inflammatory disease, Fractures, pulmonary heart disease, superficial trauma, chronic cholecystitis, arthritis. ④ In 2008 and 2009, the major disease burden of inpatient cases was concentrated in the 35- to 54-year-old age group, followed by the 55-year-old and above age groups. Most of the patients were female except for injury and poisoning. Pulmonary infection concentrated after 35 years of age; hypertension increased significantly in 2008 in 45 to 54 years of age more in 2009 in 35 to 44 years of age more common. ⑤ nearly 3 years ago 15 single disease patients constitute 64.06% ~ 71.21%, with 8 to 9 kinds of chronic diseases, and in 2010 ranked the front. There are 6 to 7 acute diseases, focusing on infection and injury. ⑥ The average cost of chronic diseases in 2010 were higher than that of acute diseases. Conclusions ① Gaozha Center Hospital is a model hospital in the west of China. No matter what the local economic level, the burden of hospitalization and the expenses are far from the health centers of Shuangliu Yong’an Center in the Well-off Demonstration Township in western part of China. ② The main systemic diseases in recent 3 years were respiratory system, circulatory system and digestive system diseases, with more chronic diseases and younger trend. Acute diseases were mainly concentrated in infections and injuries, and pulmonary infection was the highest in nearly 3 years. ③ In 2008 and 2009, the number of inpatient cases was mainly between 35 and 54 years old, followed by those aged 55 and over. Most of them were female except for injuries and poisoning. ④ In 2010, per capita hospitalization expenses and per capita expenses for hospitalized patients with chronic diseases are lower than those for Yongan Central Hospital, and the reasonableness of hospital expenses should be considered. ⑤ The hospital information infrastructure and infrastructure construction should be strengthened and improved urgently.