2019-2024年上海市市级医院儿内科重点病种收治现况和直接疾病经济负担的横断面调查  

Cross-sectional survey on the status and direct economic burden of common pediatric diseases in municipal hospitals in Shanghai(2019 to 2024)

作　　者：刘枭雄[1] 柳龚堡[1] 桂永浩[1,5] 侯冷晨 余松轩 叶颖子[1] 王淼[3] 王颖雯[1] 鲁冰 冯瑞[4] 张崇凡[1] 王艺[1] 张晓波[1,5] LIU Xiaoxiong;LIU Gongbao;GUI Yonghao;HOU Lengchen;YU Songxuan;YE Yingzi;WANG Miao;WANG Yingwen;LU Bing;FENG Rui;ZHANG Chongfan;WANG Yi;ZHANG Xiaobo(National Children's Medical Center/Children's Hospital of Fudan University,Shanghai 201102,China;Shanghai Hospital Development Center,Shanghai 200041,China;Shanghai Children's Hospital,Shanghai 200062,China;School of Computer Science,Fudan University,Shanghai 200438,China;National Health Commission(NHC)Key Laboratory of Neonatal Diseases(Fudan University),Shanghai 201102,China;Co-first author)

机构地区：[1]国家儿童医学中心复旦大学附属儿科医院,上海201102 [2]上海市申康医院发展中心,上海200041 [3]上海市儿童医院,上海200062 [4]复旦大学计算机科学技术学院,上海200438 [5]国家卫生健康委员会新生儿疾病重点实验室(复旦大学),上海201102

出　　处：《中国循证儿科杂志》2025年第2期95-101,共7页Chinese Journal of Evidence Based Pediatrics

基　　金：上海市市级医院新兴前沿联合攻关项目:SHDC12024136;上海市促进产业高质量发展专项先导产业创新发展项目:2024-GZL-RGZN-01013;上海市级医院小儿内科专科联盟项目:SHDC22024307-A。

摘　　要：背景当前缺乏儿科常见重点疾病收治现况和直接疾病经济负担的描述性数据,影响相关干预措施和政策制定的针对性和有效性。目的了解上海市22家市级医院儿内科11个重点病种住院患儿的收治现状和直接疾病经济负担。设计横断面调查。方法通过上海市市级医院医疗质量评价与促进平台,回顾性收集2019年3月1日至2024年6月30日上海市22家儿内科联盟成员单位11个重点病种的住院患儿病案首页数据,采用描述性方法分析所监测重点病种的收治现状,包括体量性指标(收治例数)、技术规范性指标(输血率和抗菌药物使用率)、重返性指标(31 d内非计划重返住院率)、安全性指标(病死率和自动出院率)、效率性指标(平均住院日)以及直接疾病经济负担指标(均次药品费用、均次耗材费用、均次总费用和医疗服务费占比)。主要结局指标儿内科重点病种的收治现状指标。结果上海市市级医院儿内科的11个重点病种中,收治体量最大的是儿童社区获得性肺炎,其次是早产儿,且经年趋势均无显著变化;病死率和自动出院率均维持在低位,儿童社区获得性肺炎的直接疾病经济负担经年下降趋势显著。结论监测疾病中感染性疾病收治体量最大,整体治疗效果佳。应增加对儿童慢性病的监测力度,并进一步提高市级医院的信息化水平。Background Existing research lacks comprehensive data on the treatment status and direct economic burden of common pediatric diseases,which hinders the development of targeted interventions and effective policies.Objective To assess the current hospitalization trends and direct economic burden associated with 11 common pediatric diseases in the pediatric departments of 22 municipal hospitals in Shanghai.Design Cross-sectional survey.Methods A retrospective study was conducted using data from the Shanghai Municipal Hospital Medical Quality Evaluation and Promotion Platform.The study focused on medical record homepages data from 11 diseases of 22 hospitals within the alliance,covering the period from March 1,2019,to June 30,2024.Descriptive statistics were applied to evaluate hospitalization trends,including case volume,technical standards(transfusion and antibiotic usage rates),readmission rates(unplanned readmission within 31 days),safety indicators(mortality and voluntary discharge rates),efficiency measures(average length of stay),and the direct economic burden(average drug costs,consumable costs,total costs per case,and proportion of healthcare service costs).Main outcome measures Status of common pediatric diseases.Results Among the 11 diseases studied,pediatric community-acquired pneumonia had the highest case volume,followed by premature infants,with no significant year-over-year trend changes.Mortality and voluntary discharge rates remained low,and the economic burden for pediatric community-acquired pneumonia decreased significantly over the study period.Conclusion Infectious diseases accounted for the majority of cases,with generally positive treatment outcomes.Increased focus on pediatric chronic diseases and further improvements in hospital informatization are recommended.

关 键 词：市级医院 儿科 疾病收治 经济负担 

分 类 号：R197.3[医药卫生—卫生事业管理]