广东省居民伤害谱及疾病负担研究

Survey on injury spectrum and economic burden of injuries in residents of Guangdong Province

目的了解广东省居民伤害谱及其疾病负担,为制定伤害干预策略提供科学依据。方法非致死性调查采用4阶段分层整群随机抽样方法抽取大、中小城市、1类和2类农村各3个县区;致死性伤害调查采取等比例分层整群随机抽样方法抽取13个调查点进行调查。结合2000年全省人口普查不同地区分年龄组和性别人口数,计算住院、门诊处理和自己/他人处理或没有处理人数分别与死亡人数的比值,绘制广东省居民伤害谱金字塔图。利用致死性调查和非致死性调查数据估算伤害造成的疾病负担。结果非致死性伤害共调查18 505人,发生伤害4 046人,发生率21.9%,标化率为21.2%。其中,城市、农村伤害发生率分别为17.7%(1 647/9 294)、26.7%(2 459/9 210);男性、女性伤害发生率分别为23.9%(2 228/9 324)、19.8%(1 818/9 168);0～19、20～59及≥60岁组人群伤害发生率分别为28.4%(2 156/7 592)、17.0%(1 432/8 437)、19.2%(458/2 388)。广东省居民伤害死亡、住院、门诊、自己/他人处理或没有处理的比例为1∶27∶126∶472;城乡居民的伤害谱比例接近,但农村(26.7%)伤害发生率高于城市(17.7%);女性(1∶35∶149∶651)伤害的伤害谱比例高于男性(1∶23∶115∶382);伤害死亡、住院、门诊、自己/他人处理或没有处理的比例随年龄增长呈下降趋势。死因回顾性调查共调查了7 721例伤害死亡病例,伤害死亡率为50.7/10万,标化率为47.8/10万,估算广东省每年因伤害死亡约38 000人,潜在寿命损失年(YPLL)为117.3万人年,城市、农村、男性、女性的YPLL分别为48.9、68.4、78.9、38.4万人年。全省主要的前7种非致死性伤害每年需要的住院和门诊费用为63亿元,其中住院52亿元、门诊11亿元。结论广东省不同地区、性别、年龄组居民伤害谱不同,疾病负担沉重,迫切需要动员资源,加强预防控制力度。

Objective To describe injury spectrum and economic burden of injury in Guangdong, and provide information for policy making. Methods Nonfatal survey was conducted by using 4 phase stratified cluster random sampling method and 3 counties were selected respectively from the big city, small city, Class I rural and Class II rural area. Thirteen survey points were selected for fatal injury survey using the proportional stratified cluster random sampling method. According to the census of 2000 in Guangdong Province, the ratios of deaths to the inpatient treatment, clinic treatment, and treatment by self/others or no treatment were calculated respectively, to draw the spectrum diagram. The fatal and nonfatal ~urvey data were used to measure and calculate the economic burden of injury. Results A total of 18 505 individuals were investigated and 4 046 were found with the nonfatal damage. The incidence rate was 21.9% and the standardized rate was 21. 2%. Of them, ihere were 1 647 people with 17.7% （1 647/9 294 ） damage rate in the city and 2 459 people with 26. 7% （2 459/9 210 ） damage rate in the rural area; 2 228 male people with 23.9% （2 228/9 324 ） damage rate and 1 818 female people with 19. 8% （ 1 818/9 168 ） damagerate; 2 156 people between 0 - 19 years old with 28.4% damage rate, 1 432 people between 20 to 59 years old with 17.0% damage rate, and 458 people at 60 years old and above with 19. 2% damage rate. The ra- tios of injury deaths to hospital treatment, clinic treatment, treatment by self / others or no treatment in Guangdong Province was 1 ： 27： 126：472 ; the urban injury spectrum ratio was close to the rural one, but ru- ral injury rate （26. 7%） was higher than city＇ s （17. 7%）; the female injury spectrum ratio （ l： 35： 149：651 ）was higher than men＇ s（ 1： 23： 115： 382）. The ratios of deaths to the inpatient treatment, clinic treatment, and treatment by self/others or no treatment decreased with the age increasing. 7 721 in- jury death cases were retrospectively investigated for the death - cause, the injury mortality was 50. 7/100 000, and the standardized rate was 47. 8/100 000. It is expected that would be 38 000 injury death cases per year and 1. 173 million years of potential life lost （YPLL） in Guangdong. The YPLL in ur- ban area, rural area, male, and female were 489 000,684 000,789 000, and 384 000, respectively. The medical cost for outpatient and hospitalization of the top 7 nonfatal injuries need 6. 3 billion Yuan, inclu- ding 5.2 billion Yuan for hospitalization and 1.1 billion Yuan for outpatient treatment. Conclusion The injury spectra were different in different regions, genders, age groups in Guangdong Province. The burden of injury was huge. It is urgent to mobilize resources and strengthen control and prevention of the injury.