2014-2018年江苏省苏州市乙型肝炎病例就诊流向和就诊医院等级分布情况  

Hospital preference in terms of area and grade for treatment in hepatitis B cases in Suzhou, 2014–2018

作　　者：杨洋 覃江纯[3] 刘成[3] 谭亚运[3] 陈立凌[3] 金连梅[2] 马会来[2] Yang Yang;Qin Jiangchun;Liu Cheng;Tan Yayun;Chen Liling;Jin Lianmei;Ma Huilai(Jiading District Center for Disease Control and Prevention,Shanghai 201899,China;Chinese Center for Disease Control and Prevention,Beijing 102206,China;Suzhou City Center for Disease Control and Prevention,Suzhou 215000,Jiangsu,China)

机构地区：[1]上海市嘉定区疾病预防控制中心,上海嘉定201899 [2]中国疾病预防控制中心,北京102206 [3]苏州市疾病预防控制中心,江苏苏州215000

出　　处：《疾病监测》2020年第4期327-332,共6页Disease Surveillance

基　　金：苏州市姑苏卫生人才培养项目(No.GSWS2019024);苏州市医学重点学科(No.Szxk201516)。

摘　　要：目的了解江苏省苏州市乙型肝炎(乙肝)病例就诊流向和就诊医院级别,为苏州市乙肝防治过程中医疗资源的合理配置提供决策依据。方法在国家法定传染病报告信息系统导出2014-2018年现住址在苏州市的乙肝确诊病例,应用Excel2013软件进行数据整理和分析,利用R软件(3.6.1版)的circlize程序包绘制苏州市乙肝病例就诊流向,用R软件中的networkD3程序包绘制病例就诊流向和就诊医院等级的桑基图,用ArcGIS 10.3软件绘制病例的外地就诊地图。结果苏州市乙肝病例跨市就诊比例为9.74%,市内各区/县的乙肝病例就诊流向主要为本区/县内就诊(64.24%);跨区域就诊主要为苏州市区病例集中流向姑苏区,下设的外围4个县级市病例流向上海市;跨区域就诊病例赴三级甲等医院比例为73.48%(3370/4586),高于本区/县内病例赴三甲医院就诊比例15.67%(1291/8237),OR=14.91(95%CI:13.65~16.29)。结论苏州市乙肝患者就诊以本区/县内医疗机构为主,跨区域就诊主要流向姑苏区和上海市两地的三级医疗机构。Objective To understand the hospital preference in terms of area and grade for treatment in hepatitis B cases in Suzhou from 2014 to 2018 and provide evidence for the rational allocation of medical resources in the prevention and treatment of hepatitis B in Suzhou. Methods The data of the confirmed hepatitis B cases with current address in Suzhou from 2014 to 2018 were collected from the National Notifiable Infectious Disease Reporting Information system(NNDRS), and the data were collated and analyzed by Excel 2013. The medical care seeking flow of the hepatitis B cases in Suzhou was drawn by using the circlize package of R software(version 3.6.1). The Sankey diagram of the medical care seeking flow and hospital grade was generated with the networkD3 package of software R, and the extra-area medical care seeking map of the hepatitis B cases was produced with software ArcGIS 10.3. Results In hepatitis B cases in Suzhou, 9.74% sought medical cares in hospitals in other cities. 64.24% sought medical cares in local hospitals of the districts or counties. The hospitals in Gusu district were the preference of hepatitis B cases in urban area of Suzhou. The hepatitis B cases in 4 outer counties of Suzhou were more likely to see doctors in hospitals in Shanghai. Up to 73.48%(3 370/4 586) of the hospitals for extra-area medical care seeking belonged to grade Ⅲ(A), while the proportion of grade Ⅲ(A) hospitals for local medical care seeking was 15.67%(1 291/8 237)(OR=14.91, 95% CI: 13.65–16.29). Conclusion Hepatitis B patients in Suzhou were mainly treated by local hospitals of districts or counties where they lived, while the patients seeking extra-area treatment mainly went to the grade Ⅲ(A) hospitals in Gusu district of Suzhou and in Shanghai.

关 键 词：乙型肝炎 数据可视化 R语言 就诊流向 卫生信息化 

分 类 号：R516.2[医药卫生—内科学]