四川省双流县永安中心卫生院2008～2010年度住院疾病构成与费用情况调查

A Status Survey on Disease Constitution and Hospitalization Cost in Yong'an Central Township Health Center,Shuangliu County of Sichuan Province from 2008 to 2010

目的调查四川省双流县永安中心卫生院2008～2010年度住院疾病构成及费用情况,为进一步研究提供基线数据。方法采取问卷调查结合专题访谈,收集该院2008～2010年住院病例资料,按国际疾病分类(ICD-10)标准对出院记录的第一诊断进行分类,应用Excel软件整理和统计分析住院患者一般信息、出院诊断名、住院费用、所用药品金额等。结果①该院2008、2009、2010年度住院病例分别为4236、4335、4844人次,均为女性多于男性(56.99%vs.42.96%,55.59%vs.44.1%,54.36%vs.45.62%);住院病例疾病谱分为20类,占ICD-10标准分类的95%。②近3年前3位系统疾病均为呼吸、消化、泌尿生殖系统疾病,累计构成比62.74%～72.31%。③近3年前15位单病种包括:上呼吸道感染、急性气管炎、肺部感染、急性胃肠炎、骨折、急性阑尾炎、慢性支气管炎、泌尿系结石、脑血管供血不足、腰椎病、急性胃炎、浅表损伤、慢性胃炎、高血压和胆囊结石/胆囊炎。④近3年15～24岁以上年龄段的慢性病住院患者人次数随其年龄增长而呈增加趋势,且女性多于男性;0～4岁年龄段均为急性病,且男性多于女性,为急性病负担最重的人群;25～54岁年龄段急性病多于慢性病,女性多于男性。⑤2010年前15位单病种中慢性病的人均住院费用高于急性病(1564.45元vs.1104.11元),也高于新添中心卫生院(人均1311.81元)和高闸中心卫生院(人均1002.99元)慢性病人均住院费用。结论①双流永安中心卫生院近3年住院病例主要系统疾病是消化、呼吸和泌尿生殖系统疾病,急性病较多且集中于感染和损伤。②该院住院患者的常见病种较稳定,近3年前15位单病种中相同疾病有上呼吸道感染、肺部感染、急性支气管炎、急性阑尾炎、急性胃炎、急性胃肠炎、骨折、慢性胃炎、慢性支气管炎和泌尿系结石。③应重点关注15～24岁以上年龄段的慢性病患者及0～4岁年龄段急性病患者。④2010年前15位单病种住院患者人均住院费用高于新添中心卫生院和高闸中心卫生院,应关注住院费用的合理性。

Objective To investigate the disease constitution and hospitalization cost in Yong＇an Central Township Health Center（YaC） in Shuangliu County of Sichuan Province from 2008 to 2010,so as to provide baseline data for further research.Methods Questionnaire and focus interview were carried out;case records and cost information of YaC inpatients in 2008,2009 and 2010 were collected.The diseases were classified according to ICD-10 based on the first diagnose and the cost was analyzed.Data including general information of the inpatients,discharge diagnosis,hospitalization expenses,and drug cost etc.were rearranged and analyzed by Excel software.Results a） The total number of inpatients were 4 236,4 335 and 4 844 in 2008,2009 and 2010,respectively.Females were more than males（56.99% vs.42.96%,55.59% vs.44.1%,54.36% vs.45.62%）,and their disease spectrum included 20 categories,which accounted for 95% of disease classes of ICD-10;b） The inpatients suffering from top three systematic diseases accounted for 62.74% to 72.31%,which included the respiratory,digestive,urinary tract and urogenital systematic disease;c） The top 15 single diseases were upper respiratory infection,acute bronchitis,pulmonary infection,acute gastroenteritis,fracture,acute appendicitis,chronic bronchitis,calculi in urinary system,cerebral vascular insufficiency,lumbar vertebra disease,acute gastritis,superficial injury,chronic gastritis,hypertension,and cholecytolithiasis or cholecystitis;d） The number of inpatients in the group of over 15-24 ages with chronic diseases increased with age and females were more than males.The acute disease burden of inpatients in 0-4 age group was the heaviest,who only suffered from acute diseases and males were more than females.The inpatients in 25-54 age group suffered from more acute diseases than chronic diseases and females were more than males;and e） The inpatients＇ average costs of chronic diseases were higher than those of acute diseases in 2010（1 564.45 yuan vs.1 104.11 yuan） and those of either Xintian Central Township Health Center（1 311.81 yuan） or Gaozha Central Township Health Center（1 002.99 yuan）.Conclusion a） In recent three years,the main systematic diseases that inpatients suffer are digestive,respiratory,and urinary tract and urogenital system diseases;the acute diseases are more than the chronic;the acute diseases mainly include infection and injury;b） During the past three years,the top 15 diseases have been stable and the same diseases include upper respiratory infection,pulmonary infection,acute bronchitis,acute appendicitis,acute gastritis,acute gastroenteritis,fracture,chronic gastritis,chronic bronchitis,and calculi in urinary system;c） It should be paid attention to the inpatients with chronic diseases in over 15-24 age group and the inpatients with acute diseases in 0-4 age group;and d） The inpatients＇ average costs of top 15 diseases in 2010 were higher than those of either XtC or GzC,and consideration on rationality of the hospitalization cost should be paid attention to.