某医院十年前后住院儿童血液系统疾病病种及疾病负担变化趋势  

The Changing Trend of Hospitalized Children's Hematologic diseases Entities and Burden before and after ten years in a Hospital

作　　者：孔宪玲[1] 林翠兰[1] 陈昂[1] 

机构地区：[1]中山市博爱医院,中山市528403

出　　处：《中国病案》2017年第5期63-65,共3页Chinese Medical Record

基　　金：中山市科技计划项目资助(20132A032)

摘　　要：目的探讨某医院近12年住院儿童血液系统疾病病种差异,探讨不同病种的疾病负担。方法从某院病案系统中导出2003年-2005年及2013年-2015年住院患儿(0岁~18岁)ICD-10编码为D50~D77的病案首页信息,分别为1595例和5173例。分析两个时间段病种构成差异,分别对各主要病种的住院日和费用进行聚类分析,探讨不同病种的疾病负担变化。结果 2003年-2005年排在前3位的病种为粒细胞减少、未特指的贫血、葡萄糖-6-磷酸脱氢酶缺乏性贫血;而2013年-2015年排在前3位的病种为未特指的贫血、粒细胞减少、β型地中海贫血。十年前后对比,未特指的贫血由15.99%上升至40.39%,β型地中海贫血由1.38%上升至17.12%,构成比增幅明显;而粒细胞减少由43.20%下降至20.47%,葡萄糖-6-磷酸脱氢酶缺乏性贫血由15.56%下降至0.67%,下降趋势明显。按照住院日和费用可分为,一类病种(常见病),住院时间短、费用低;二类病种(发病率低),住院时间长、费用高。十年前后对比,两类病种的构成有所不同。结论儿童血液系统疾病病种和疾病负担变化呈现一定规律,应采取针对性措施,提高卫生资源配置效率,做好儿童血液系统疾病防控。Objectives To explore the changing trend of hematologic diseases from 2003-2005 to 2013-2015 in a hospital, and analyze the disease burden of different diseases. Methods To export the medical record information of hospitalized children （0 to 18y, ICD10：D50 - D77） including the main diagnostic and secondary diagnoses from the medical record system in a hospital from 2003-2005 to 2013-2015, make clustering analysis on the hospitalization days and expenses and investigate the changing trend of diseases burden. Results The top three diseases during 2003 to 2005 were granulocytopenia, not especially anemia, lack of glucose - 6-phosphate dehydrogenase anemia, and the top three diseases during 2013 to 2015 were anemia, not specifically granulocytopenia, beta thalassaemia. A comparison before and after ten years, the anemia （from 15.99% to 15.99%）, beta thalassaemia （made up of 1.38% to 17.12%） increased obviously, while granulocytopenia （from 43.20% to 20. 47%）, lack of glucose - 6 - phosphate dehydrogenase anemia （from 15.56% to 0.67%） declined significantly. According to confinement and cost, they can be divided into two kinds of diseases, one kind （shorter hospitalization time, low cost）, and the other （long hospital stay, high cost）. By the contrast of before and after ten years, the composition of two kinds of diseases were different. Conclusions The entities of hematologic diseases in children and the change of disease burden presented a certain regularity. We should take targeted measures to improve the efficiency of allocation of health resources for the control and prevention of children hematologic diseases.

关 键 词：儿童 血液系统疾病 病种 ICD-10 聚类分析 

分 类 号：R197.3[医药卫生—卫生事业管理] R725.5[医药卫生—公共卫生与预防医学]