脑血管老年患者疾病特征与住院负担分析  

Analysis of disease characteristics and hospitalization burden of elderly patients with cerebrovascular disease based on home page of medical records

作　　者：张海波[1] 谢佳东 何佳怡 李思 张磊 陈彦[1] 申俊龙 赵玉凤[5] 赵俊[1] Zhang Haibo;Xie Jiadong;He Jiayi;Li Si;Zhang Lei;Chen Yan;Shen Junlong;Zhao Yufeng;Zhao Jun(The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;School of Artificial Intelligence and Information Technology,Nanjing University of Chinese Medicine,Nanjing 210023;School of Public Administration,Hohai University,Nanjing 211100;School of Health Economies and Management,Nanjing University of Chinese Medicine,Nanjing 210023;Data Center,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]南京医科大学第一附属医院,南京210029 [2]南京中医药大学人工智能与信息技术学院,南京210023 [3]河海大学公共管理学院,南京211100 [4]南京中医药大学卫生经济管理学院,南京210023 [5]中国中医科学院中医药数据中心,北京100700

出　　处：《中华老年医学杂志》2023年第5期519-524,共6页Chinese Journal of Geriatrics

基　　金：国家重点研发计划项目(2017YFC1703503);中国博士后科学基金面上项目(2021M701492);南京医科大学第一附属医院青年基金培育项目(PY2021045)。

摘　　要：目的分析脑血管老年住院患者疾病特征和住院负担,为老年共病患者的疾病预防、诊治和康复提供依据。方法回顾性调取江苏省某综合三甲医院2015—2020年脑血管老年住院患者的病案首页数据,利用SPSS统计和Python复杂网络等方法对研究对象开展描述性分析、方差分析和多元线性回归法分析。结果共纳入14657例老年脑血管住院患者。2015—2020年,住院人数由1268例增加至4733例,平均住院次数由2.0次增加至2.9次,平均住院天数由11.9 d下降至9.1 d,平均患病数量由1.9种增加至4.9种。脑血管共病最常见的5种疾病分别是高血压、糖尿病、缺血性心脏病、其他类型的心脏病和呼吸系统的其他疾病。2015—2020年,老年脑血管住院患者的次均住院费由20588.1元下降至15580.9元,住院费主要由药物费(46.6%)、诊断费(28.2%)和医疗治疗费(20.2%)构成。不同性别、年龄、住院次数、住院天数和患病数量的患者间的均次住院费用差异均有统计学意义(均P<0.05),性别、年龄、住院次数和住院天数对住院费用产生影响。结论老年脑血管住院患者的住院人数、患病数量、住院次数呈增高趋势,同时住院天数和均次住院费用呈下降趋势,脑血管共病应成为老年慢性病管理的关注点之一。Objective To analyze the disease characteristics and hospitalization burden of elderly inpatients with cerebrovascular disease,so as to provide basis for disease prevention,diagnosis,treatment and rehabilitation of elderly patients with multiple chronic conditions.Methods The data of the first page of medical records of elderly inpatients with cerebrovascular disease from 2015 to 2020 in a comprehensive tertiary hospital in Jiangsu Province were retrospectively collected.Descriptive analysis,variance analysis and multiple linear regression analysis were carried out for the research objects using SPSS statistics and Python complex network methods.Results A total of 14657 elderly inpatients with cerebrovascular disease were included.From 2015 to 2020,the number of hospitalizations increased from 1268 to 4733,the average number of hospitalizations increased from 2.0 to 2.9,the average length of stay decreased from 11.9 days to 9.1 days,and the average number of illnesses increased from 1.9 to 4.9.The five most common comorbidities associated with cerebrovascular diseases were hypertension,diabetes,ischemic heart disease,other types of heart disease and other respiratory diseases.From 2015 to 2020,the average hospitalization costs of elderly cerebrovascular inpatients decreased from 20588.1 Chinese yuan(CYN)to 15580.9 Chinese yuan(CYN).The hospitalization cost was mainly composed of drug cost(46.6%),diagnosis cost(28.2%)and treatment cost(20.2%).There were significant differences in the average hospitalization expenses among patients with different gender,age,number of admissions,length of stay and number of diseases(P<0.05 for all).Gender,age,number of hospitalizations and length of stay had an impact on hospitalization expenses.Conclusions The number of inpatients,comorbidities,and hospitalized times of elderly patients with cerebrovascular disease showed an increasing trend,while the number of hospitalization days and the average hospitalization cost showed a downward trend.Comorbidities associated with cerebrovas

关 键 词：病案 脑血管病 疾病特征 住院负担 

分 类 号：R743[医药卫生—神经病学与精神病学]