2003—2018年某三级甲等医院6833例死亡病例分析  

Analysis of 6833 death cases in a tertiary hospital from 2003 to 2018

作　　者：陈淡芬 文建珍[1] 徐素梅[1] Chen Danfen;Wen Jianzhen;Xu Sumei(Medical Record Management Department, the Fifth Affiliated Hospital of Sun-Yat University, Zhuhai 519000, China)

机构地区：[1]中山大学附属第五医院病案管理科,广东珠海519000

出　　处：《中国医院统计》2020年第2期119-123,共5页Chinese Journal of Hospital Statistics

摘　　要：目的对某三级甲等医院2003—2018年死亡病例进行回顾分析,了解该院死亡病例的基本情况、主要死因顺位及费用相关情况,为进一步开展疾病的诊治,降低患者病死率提供参考。方法利用医院的病案信息系统,收集整理某院2003—2018年住院总人数,使用Excel 2007和SPSS 19.0软件对6833例住院期间死亡患者的病例资料进行统计分析。结果2003—2018年某院住院患者总人数为404076例,死亡患者共6833例,病死率为1.69%。16年来死亡人数逐年升高,但病死率呈现逐年下降的趋势。病死率最高的是81岁及以上人群组(6.18%),其次为71~80岁人群组(4.06%);死亡人数构成比最高的是61~70岁人群组(21.04%),其次是71~80岁人群组(21.03%)。不同年龄段患者病死率差异有统计学意义(χ2=4071.81,P<0.01)。男性病死率(2.16%)高于女性(1.22%),差异有统计学意义(χ2=540.16,P<0.01)。肿瘤、循环系统疾病、呼吸系统疾病、消化系统疾病和损伤、中毒和外因的某些其他后果是构成主要死因的疾病分类,占死亡总人数的89.56%。死亡患者主要病种前10位分别是肺癌、肝癌、胃癌、脑出血、乳腺癌、结肠癌、颅脑损伤、肺炎、脑梗死和鼻咽癌。住院总费用16年来增长了31.46%,住院天数和抢救次数对总费用有影响,药占比2011年开始每年有所下降。结论2003—2018年某医院死亡患者多为中老年男性患者,肿瘤和循环系统疾病是主要致死的疾病类型,肺癌、肝癌和胃癌是致死的主要病种,平均住院费用每年增加,且与住院天数和抢救次数成正比。医院相关部门应合理配置医疗资源,加强对肿瘤、循环系统疾病和呼吸系统疾病的学科建设,以降低患者的病死率,同时控制住院天数及进行合理抢救,控制总住院费用。Objective To review and analyze the death cases from 2003 to 2018 in a tertiary hospital,to find out the basic situation of the death cases,the main causes of death and the related expenses,in order to provide reference for diagnosis and treatment of the disease,and reduce the case fatality rate.Methods The total number of inpatients from 2003 to 2018 was collected from the hospital medical record information system,and the data of 6833 inpatients who died in the hospital were analyzed by using Excel 2007 and SPSS 19.0 softwares.Results From 2003 to 2018,the total number of inpatients was 404076,and 6833 patients died,with the case fatality rate 1.69%.The death cases have been increasing year by year in the past 16 years,but the fatality rate has been decreasing year by year.The highest mortality rate was 6.18%in the group aged over 81,followed by 4.06%in the group aged 71~80,and the highest mortality ratio was 21.04%in the group aged 61~70,followed by 21.03%in the group aged 71~80.There was a significant difference in mortality among different age groups(χ2=4071.81,P<0.01).The mortality rate of male(2.16%)was significantly higher than that of female(1.22%)with significant statistical difference(χ2=540.16,P<0.01).Tumors,cardiovascular diseases,respiratory diseases,gastrointestinal diseases,poisoning and external causes were the main causes of death,accounting for 89.56%of the total number of deaths.The top 10 leading causes of death were lung cancer,liver cancer,stomach cancer,brain hemorrhage,breast cancer,colon cancer,brain injury,pneumonia,cerebral infarction and nasopharyngeal carcinoma.The total cost of hospitalization has increased 31.46%in the past 16 years.The hospital stays and rescue times have impacted the total cost,and the proportion of drugs has decreased every year since 2011.Conclusion From 2003 to 2018,most of the patients who died in the hospital were middle-aged and elderly male patients.Tumor and cardiovascular disease were the main disease causes of death.Lung Cancer,liver cancer and stomac

关 键 词：死亡病例 疾病分类 统计分析 

分 类 号：R195.4[医药卫生—卫生统计学]