成都市第三人民医院骨科2009年住院患者疾病及费用构成现状调查  

Status Survey on Inpatient's Disease and Cost Constitution of the Third People's Hospital of Chengdu in 2009

作　　者：薛力[1,2] 查莉 李康仁[2] 蔡波涛[4] 李鸿浩[1] 陈丽[5] 秦辉[2] 邓宁[2] 余彬[2] 李幼平[1] 

机构地区：[1]四川大学华西医院中国循证医学中心,成都610041 [2]成都市第三人民医院骨科,成都610031 [3]成都市妇女儿童中心医院,成都610091 [4]成都市金堂县第二人民医院骨科,成都610404 [5]成都市第三人民医院病案科,成都610031

出　　处：《中国循证医学杂志》2012年第11期1296-1301,共6页Chinese Journal of Evidence-based Medicine

基　　金："十一五"国家科技支撑计划资助(编号:2008BAI65B22)

摘　　要：目的调查成都市第三人民医院骨科2009年住院患者的疾病构成,为进一步研究提供基线数据。方法收集成都市第三人民医院骨科2009年住院患者的病历,按照国际疾病分类(ICD-10)标准对出院记录的第一诊断进行分类整理,然后采用Excel软件进行数据整理和统计分析。结果①该院骨科2009年住院患者共1 220人次,男性多于女性,其疾病谱可分为12类。②前三位住院系统疾病分别是损伤与中毒、肌肉骨骼系统和结缔组织疾患、影响健康状态和与保健机构接触的因素。其中除肌肉骨骼系统和结缔组织疾患外,其余2类系统疾病的住院患者均为男性多于女性。③按照ICD-10标准,损伤与中毒的前九位病种依次为腕和手损伤、髋和大腿损伤、膝与小腿损伤、肩与上臂损伤、下背腰椎骨盆损伤、肘与前臂损伤、胸部损伤、颈部损伤和足踝损伤;在肌肉骨骼系统和结缔组织疾患中的病种依次为背部病、软组织疾患、关节病和骨病软骨病。④在损伤与中毒中排名前五位的单病种依次为腕和手的肌肉肌腱损伤、股骨粗隆间骨折、股骨颈骨折、胫腓骨骨折和腰椎骨折;在影响健康状态和与保健机构接触的因素中,排名前五位的单病种依次为腰椎间盘突出症、脊椎关节强硬、膝关节病、骨质疏松伴病理性骨折和骨坏死。⑤该院骨科2009年人均住院日为23.55天,人均费用为13 073.73元,费用构成包括材料费、药品费(含西药费和中药费)、治疗费(含治疗费和输血费)和手术费(含麻醉费)等。住院费用支付仍以自费为主,社保支付方式占总费用的近一半,公费支付方式仅占总费用不足3%。结论①2009年成都市第三人民医院骨科住院病例中,男性多于女性,且以中、青年为主,而女性以老年为主;主要是损伤与中毒、肌肉骨骼系统和结缔组织疾患、影响健康状态和与保健机构接触的因素三类系统疾病。�Objective To investigate the inpatient＇s disease and cost constitution of the Third People＇s Hospital of Chengdu in 2009, so as to provide baseline data for further research. Methods The case records of inpatients in the Third People＇s Hospital of Chengdu in 2009 were collected, and based on the first diagnose, the diseases were classified ac- cording to the International Classification of Diseases （ICD-10）. The data including general information of the inpatients, discharge diagnosis and hospitalization expense etc. were rearranged and analyzed using Excel software. Results a） The total number of inpatients was 1 220, and male was more than female. The disease spectrum included 12 categories, b） A total of 1 093 inpatients suffered from the top 3 systematic diseases as follows： trauma and toxicosis, musculoskeletal system and connective tissue disorders, and the factors affecting health and resulting from contact with health care insti- tutions. Except the musculoskeletal system and connective tissue disorders, the other 2 systematic diseases were mostly seen in male rather than in female, c） According to ICD-10, the top 9 diseases of trauma and toxicosis were injuries to the wrist and hand, injuries to the hip and thigh, injuries to the knee and lower leg, injuries to the shoulder and upper arm, injuries to the lower back, lumbar spine and pelvis, injuries to the elbow and forearm, injuries to the thorax, injuries to the neck and injuries to the ankle and foot; the top 4 diseases in musculoskeletal system and connective tissue disorders were dorsopathies, soft tissue disorders, arthrosis, and osteopathies and chondropathies; among the factors affecting health and resulting from contact with health care institutions, removal of fracture fixation device, d） According to ICD-10 （list of three-digit catalogue and four-digit sub-catalogue）, the top 5 single diseases in trauma and toxicosis were muscle and ten- don injuries of the wrist and hand, intertrochanteric frature, fracture of the femo

关 键 词：三级甲等综合性医院 骨科 疾病构成 费用构成 调查分析 

分 类 号：R197.3[医药卫生—卫生事业管理]