西部地区某三甲医院2008－2012年老年住院患者疾病及费用构成调查

Status Survey on Old Inpatient's Disease and Cost Constitution of a Tertiary Hospital in West China from 2008 to 2012

目的调查西部地区某三甲医院2008－2012年老年（60岁以上）住院患者的疾病和费用构成,为进一步研究提供基线资料。方法通过该医院的病案数据库提取2008－2012年60岁以上患者的住院资料和费用情况,按照国际疾病分类（ICD-10）对主要出院诊断进行分类,采用Stata 12.0进行统计分析。统计资料包括患者的一般资料、主要诊断、住院天数和住院费用等。结果 1该院2008－2012年60岁以上住院患者共109 585例,其中男性占59.57%,女性占40.43%。老年住院患者疾病包括18个类别疾病,人数占总住院患者的比例由2008年的31.57%上升到2010年的34.25%。2前三位疾病为肿瘤、循环系统疾病和消化系统疾病,男性多于女性,其数量随年龄增长而下降,其中肿瘤最常见,恶性肿瘤患者共34 944例。3男性和女性患者中前五位恶性肿瘤疾病累计构成比分别为62.51%和49.44%,其中男性前五位为支气管肺癌、恶性肿瘤术后化疗、食管癌、胃癌和前列腺癌,而女性前五位为恶性肿瘤术后化疗、支气管肺癌、乳腺癌、胃癌和宫颈癌。4平均住院天数由2008年的14.12天降至2012年的11.00天,人均住院费用由2008年的14 044.79元增至2012年的18 932.81元;患者住院治疗总费用中药品费用占比由2008年的47.21%降至2012年的42.16%。结论该院2008－2012年老年住院患者男性多于女性。最常见的系统疾病为肿瘤,其中恶性肿瘤占比最高;老年住院患者前五位恶性肿瘤疾病在男性与女性间存在一定差别;平均住院日在最近五年内呈现下降趋势,而人均住院费用出现上升趋势。

Objective To investigate old（the no less than 60-year-old） inpatient＇s diseases and cost constitution of a tertiary hospital in West China from 2008 to 2012, so as to provide baseline data for further research. Methods The case records of no less than 60-year-old inpatients in the tertiary hospital were collected from 2008 to 2012, and based on the first diagnose, the diseases were classified according to the International Classification of Diseases（ICD-10）. The data including general information of the inpatients, discharge diagnosis, length of hospital stay and hospitalization costs, were analyzed using Stata10.0 software. Results a） The total number of old inpatients was 109 585, and male（59.57%） was more than female（40.43%）. The disease spectrum included 18 categories. The percentage of old inpatients increased from 31.57%（2008） to 34.25%（2010）. b） The top three systematic diseases were neoplasms, diseases of the circulatory system and diseases of the digestive; the male inpatients were more than the female; the number of inpatients who suffered from the top three systematic diseases got decreased with age increasing; neoplasm was the most common disease, there were 34 944 malignant neoplasm inpatients. c） The cumulative constituent ratio of the top five malignant neoplasms in male and female inpatients were respectively 62.51% and 49.44%; and the top five malignant neoplasms of male inpatients were malignant neoplasm of bronchus and lung, other medical care for neoplasm, malignant neoplasm of esophagus, malignant neoplasm of stomach and malignant neoplasm of prostate. The top five malignant neoplasms of female inpatients were other medical care for neoplasm, malignant neoplasm of bronchus and lung, malignant neoplasm of breast, malignant neoplasm of stomach and malignant neoplasm of cervix uteri. d） The average length of hospital stay decreased from 14.12 days to 11.00 days since 2008, and the average cost per capita increased from $14 044.79 yuan to $18 932.81 yuan since 2008. The proportion of drug cost of inpatients hospitalization cost decreased from 47.21% to 42.16% since 2008. Conclusion The male inpatients are more than female in the tertiary hospital from 2008 to 2012. The most common systematic disease is neoplasm, especially the malignant neoplasms with higher constituent ratio. The top five malignant neoplasms of male inpatients and female are different. The average length of stay in hospitals has declined in five years, however the average cost per capita has increased.