天津市2018—2020年全人群及老年住院患者疾病谱及疾病模式变化分析  

Analysis of changes in the disease spectrum and disease patterns of the entire population and elderly hospitalized patients in Tianjin between 2018 and 2020

作　　者：高晗 李岱[1] 张释双[1] 张琳[1] 张岚[1] 韩召利 孙蓬飞 周欣 陈芳莲[3] 雷平[1] Gao Han;Li Dai;Zhang Shishuang;Zhang Lin;Zhang Lan;Han Zhaoli;Sun Pengfei;Zhou Xin;Chen Fanglian;Lei Ping(Department of Geriatrics,Tianjin Medical University General Hospital,Tianjin 300052,China;Department of Cardiovascular Medicine,Tianjin Medical University General Hospital,Tianjin 300052,China;Tianjin Institute of Neurology,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院保健医疗部(老年病科),天津300052 [2]天津医科大学总医院心血管内科,天津300052 [3]天津市神经病学研究所,天津300052

出　　处：《中华老年医学杂志》2024年第10期1315-1320,共6页Chinese Journal of Geriatrics

基　　金：天津市智能制造专项资金项目(20201194);天津市卫生健康科技项目(KJ20177)。

摘　　要：目的通过分析天津市2018—2020年全人群及老年住院患者疾病谱构成及住院疾病模式,了解居民健康水平及疾病特点,为疾病防治提供科学依据。方法研究纳入天津健康医疗大数据平台77家二级以上医院住院患者病案首页相关信息,根据国际疾病分类编码(ICD-10)标准化出院诊断并按系统归类,对住院患者各系统疾病进行疾病谱分析,并按照年龄和分层分析疾病谱顺位变化情况。结果2018—2020年共计出院3568034人次,2018、2019、2020年出院人次分别为1204733人次、1372747人次、990554人次,男性占比49.2%(1756867/3568034),65岁及以上老年患者占比33.5%(1194189/3568034),三级医院出院人次占比86.5%(3085482/3568034)。根据ICD-10分类后,患者出院诊断共涉及19种系统疾病,3年间前10位疾病出院人次占总出院人次的81.1%(2893430/3568034),且顺位一致性较高(和谐指数Wa=0.986、χ^(2)=70.989、P<0.001),顺位第1位和第2位始终为循环系统疾病和神经系统疾病,呼吸系统疾病顺位于2020年由第3位降至第7位,影响健康与保健接触的因素顺位上升。循环系统、神经系统、呼吸系统、消化系统、肿瘤相关疾病始终位居老年人疾病谱顺位前6位,眼耳、内分泌以及肌肉骨骼系统和结缔组织系统相关疾病顺位排序较全人群有所提升。结论住院患者主要集中在三级医院,且老年患者占比较高;疾病谱中循环、神经、消化、肿瘤及呼吸系统疾病始终位居全人群及老年患者就诊前列,其中2020年呼吸系统疾病顺位下降明显;老年患者中眼耳、内分泌以及肌肉骨骼系统和结缔组织系统疾病顺位较全人群有所提升,应加强老年医学及相关学科专业建设,对推进健康中国建设和健康老龄化具有重要意义。Objective To understand residents'health status and disease characteristics by analyzing the disease spectrum and disease patterns of the entire population and elderly hospitalized patients in Tianjin between 2018 and 2020,thus providing scientific evidence for disease prevention and treatment.Methods Information on the first page of inpatient medical records from 77 secondary or higher-level hospitals was provided by the Tianjin Health and Medical Big Data Platform.The codes of the International Classification of Diseases 10th revision(ICD-10)were used by the system for standardized diagnoses at hospital discharge.The disease spectrum of inpatients was analyzed based on the systems implicated by diseases.Age stratification was performed in examining changes in the orders of diseases across the spectrum.Results Between 2018 and 2020,a total of 3568034 patients were discharged,with 1204733 in 2018,1372747 in 2019,and 990554 in 2020.Male patients accounted for 49.2%(1756867/3568034),elderly patients(65 years or older)accounted for 33.5%(1194189/3568034),and patients from tertiary hospitals accounted for 86.5%(3085482/3568034).According to the ICD-10,there were 19 categories of diseases when diagnoses at discharge were considered.Over the three-years period,the top ten diseases made up 81.1%(2893430/3568034)of all cases at discharge,with high consistency in their rankings(harmonic index value Wa=0.986,χ^(2)=70.989,P<0.001).The circulatory system and the nervous system always occupied the top two positions,while the respiratory system decreased from third to seventh place in 2020.The rankings of factors affecting health and healthcare access increased.The circulatory system,nervous system,respiratory system,digestive system,and tumors consistently ranked among the top six categories in the disease spectrum of the elderly and the rankings of diseases related to the eye,ear,endocrine system,musculoskeletal system,and connective tissue system were also up compared to those of the entire population.Conclusions Hospitali

关 键 词：住院患者 疾病谱 疾病顺位 

分 类 号：R195.4[医药卫生—卫生统计学]