成都市新津县公益性医疗卫生服务体系改革绩效评估系列之四:新津县各级医疗机构门、急诊与住院疾病构成调查  

Performance Evaluation of Primary Healthcare System Reform in Xinjin County, Chengdu City: Ⅳ. Survey on Out-patient and In-patient Disease Composition of Different Levels of Hospitals

作　　者：王莉[1] 李萃萃[1] 李幼平[1] 师成虎[1] 杨宗霞[1] 王应强[1] 沈建通[1] 李筱[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

出　　处：《中国循证医学杂志》2014年第2期140-146,共7页Chinese Journal of Evidence-based Medicine

基　　金：成都市卫生局资助项目"新津县公益性医疗卫生服务体系改革绩效评估"(编号:H1106077)

摘　　要：目的调查新津县各级医疗机构2009和2010年门、急诊和住院疾病构成情况,为进一步研究提供基线数据。方法收集2009和2010新津县县级医院、社区卫生服务中心和乡镇卫生院共17家医疗机构门、急诊及住院患者ICD-10系统疾病构成和单病种构成数据。采用Microsot Excel 2003和SPSS 13.0软件进行统计分析。结果①2009和2010年,全县各级医疗机构门、急诊前20位疾病就诊人次年增长106.8%,住院人次年增长43.2%。按ICD-10标准分类,门、急诊疾病谱为11类,2009和2010年前3类系统疾病均为呼吸系统疾病、消化系统疾病、损伤、中毒和外因的某些其他后果,累计构成比分别为85.1%和82.7%。2009和2010年前3位单病种均为上呼吸道感染、急性支气管炎和浅表损伤,累计构成比分别为61.6%和59.5%。②住院患者疾病谱为12类,2009和2010年前4类系统疾病均为呼吸系统疾病、妊娠、分娩和产褥期疾病、消化系统疾病和循环系统疾病,其中呼吸系统疾病均居首位,累计构成比分别为53.6%和50.8%。2009和2010年前4位单病种均为急性支气管炎、慢性支气管炎、慢性阻塞性肺疾病和急性胃炎,累计构成比分别为48.12%和49.54%。另外,高血压、糖尿病住院人次增加明显,上升至住院前10位单病种。③急性系统疾病多分布在乡院,慢性系统疾病多分布在县级医院。结论新津县2009和2010年主要系统疾病为呼吸、消化和循环系统疾病,其中县级医院以慢病为主,社区/乡院以急性感染性疾病为主。该县常见病种较集中且稳定,为基本医疗项目和基本药物的遴选提供了良好条件。Objective To investigate the burden of disease in Xinjin county of Chengdu city from 2009 to 2010. so as to provide baseline data for the study on the healthcare service system. Methods The prevalence of diseases among outpatients and inpatients in Xinjin county was collected and then analyzed using Microsoft Excel 2003 and SPSS 13.0 software. Results a） The numbers of out-patient and in-patients with the top 20 diseases had been increased by 106.8% and 43.2%, respectively in 2010 than those in 2009. According to International Statistical Classification of Diseases （ICD）- 10, the diagnosis of the diseases involved in 11 types of diseases among outpatients. For out-patients, the top 3 categories were diseases of respiratory, digestive systems and injury, poisoning and certain other consequences of external causes, accounting for 85.06% and 82.69% of total diseases in 2009 and 2010, respectively. Among them, upper respiratory infections, acute bronchitis and superficial injury cumulatively accounted for 61.61% in 2009 and 59.53% in 2010. b） The diagnosis of the diseases involved in 12 types of diseases among in-patients. For in-patients, the top 4 categories were diseases of the respiratory system, pregnancy, disease during childbirth and puerperium, digestive and the circulatory systems. Among them, the diseases of the respiratory system accounted for 53.55% and 50.82% in 2009 and 2010, respectively. The top 4 diseases among in-patients were acute bronchitis, chronic bronchitis, COPD, and acute gastritis, accounting for 48.12% and 49.54% cumulatively in 2009 and 2010. Meanwhile, the prevalence of hypertension and diabetes increased dramatically into the top 10 diseases, c） The acute diseases were mainly distributed in township hospitals, while the chronic diseases were mainly distributed in county-level hospitals. Conclusion 3he major burden of diseases is the diseases of the respiratory, digestive and circulatory diseases in Xinjin county of Chengdu city from 2009 to 2010. The chronic diseases are mainl

关 键 词：疾病负担 新津县 ICD-10 单病种 横断面调查 

分 类 号：R197.1[医药卫生—卫生事业管理]