北京市某高校1811例转诊病例的慢性病情况分析

Analysis of 1 811 referral patients with chronic disease in a college of Beijing

目的 通过校级课题项目完成教职工群体的主要慢性病现状分析,为科学开展慢性病健康管理提供参考依据。方法 整群抽取1 811例教职工的6 440份转至上级医院的病案资料,采用Epidata 3.1统计软件建立数据库,采用SPSS 13.0统计软件进行分析。结果 患病率前10位的慢性病依次为高血压、冠心病、高脂血症、糖尿病、脑血管病、骨质疏松症、骨关节病、精神心理疾患、慢性肾功能不全、慢性胃肠炎。经校医院转诊的59.59%为慢性病患者,慢性病患病率达到59.58%,患病率随年龄增长而增长（χ-2_（趋势）=346.728,P〈0.001）,患病率的性别差异无统计学意义（χ-2=2.726,P=0.101）。年度内转诊就诊次数慢性病患者约为非慢性病患者的3倍。慢性病次均费用约为非慢性病患者的2倍,慢性病患者的药占比为75.33%。慢性病共患病种类3种及以上的占53.85%。慢性病共患病数量对次均费用有显著的影响（χ-2趋势=287.209,P〈0.001）。结论 高校医院是教职工慢性病防治的主要阵地,提高慢性病常用药物的可及性、制定并实施慢性病分层健康管理策略,可以更好地发挥高校医院“健康守门人”的作用。

Objective To investigate the prevalence of common chronic diseases among the college staffs,and provide reference for the scientific management of chronic diseases. Methods A total of 6 440 referral reimbursement receipts to the higher level hospital were chosen to establish a database through Epidata and analyzed with SPSS. Results The top ten of morbidity were hypertension,coronary heart disease,hyperlipidemia,diabetes,cerebral vascular disease,osteoporosis,bone and joint disease,mental disorders,chronic renal function insufficiency,chronic gastroenteritis. 59. 59% of the referral patients were chronic patients and the prevalence increased with age（ χ-2trend= 346. 728,P〈0. 001）. But the gender difference was not significant（ χ-2= 2. 726,P = 0. 101）. The treatment number of chronic patients was 3 times that of nonchronic ones in the study time period. Of the total cost,89. 64% was for the chronic patients. The average cost by chronic patients was nearly twice as much as the non-chronic ones. And,the medicine cost by chronic patients accounted for75. 33%. Among the chronic patients,53. 85% suffered at least 3 kinds of diseases. The total number diseases suffered by chronic patients had a significant effect on the average cost（ χ-2trend= 287. 209,P〈0. 001）. Conclusion The college hospital is a main position to prevent and control the chronic diseases. Therefore,to improve the availability of the commonly used medicine and formulate chronic disease stratification strategy of health management can help them to play a greater role as the ‘Health Keeper＇.