河北省某三级综合医院全科医学科住院患者疾病谱分析

Disease profile of inpatients in general practice department of a Grade A tertiary hospital

目的 了解三级综合性医院全科医学科住院患者疾病谱构成,旨在探讨综合性医院设置全科医学科的作用和意义.方法 回顾性分析2013年11月至2016年3月于河北医科大学第二医院全科医学科住院的3 963例患者的来源、人院诊断、出院诊断及多病共存情况.结果 3 963例次全科医学科住院患者中,急诊科收入426例次（10.8％）,各专科转入115例次（2.9％）,全科门诊收入3 184例次（80.3％）.入院诊断中,头痛、头晕或晕厥待查（1 162例次,29.3％）为住院患者的首位疾病,其次为发热原因待查（887例次,22.4％）、脑血管病患者（297例次,7.5％）等,还包括未分化疾病患者（3 336例次,84.2％）.出院诊断包括神经系统疾病（1 194例次,30.1％）、呼吸系统疾病（715例次,18.0％）、循环系统疾病（625例次,15.8％）、消化系统疾病（498例次,12.6％）、内分泌系统疾病（187例次,4.7％）等.出院诊断只有1种疾病者433例次（10.9％）,合并1种慢性病者934例次（23.6％）,其余患者均合并有2种或2种以上慢性病.经全科诊治后,需转入专科治疗者243例次（6.1％）,因病情需转往上级医院者112例次（2.8％）,自动出院34例次（0.9％）,死亡4例（0.1％）,余患者均在全科医学科治疗好转或痊愈.结论 三级综合性医院全科医学科住院患者疾病谱包括未分化疾病、各个系统常见病、多发病和慢性病,多病共存现象常见,其疾病谱构成类似社区卫生服务中心,提示综合性医院的全科医学科可以弥补专科化服务的不足,满足患者的基本医疗需求.

Objective To analyze the disease profile of inpatients from general practice department in a Grade A tertiary hospital.Methods Information of 3 963 inpatients admitted in general practice department of the Second Hospital of Hebei Medical University from November 2013 to March 2016 was retrospectively analyzed.Results Inpatients were admitted from emergency department （10.8%）,specialist departments（2.9%） or general practice department（80.3%）.The most frequent diagnosis was headache,dizziness or syncope of unknown origin （29.3%）,followed by fever of unknown origin （22.4%）,cerebrovascular diseases （7.5%）.Undifferentiated diseases accounted for 84.2% of all conditions;the diagnostic categories included common diseases,multiple diseases and chronic diseases of all systems.In the discharged patients,10.9% had one single diagnosis,23.6% had one comorbidity of chronic diseases,the remaining had two and more comorbidities of chronic diseases.Most inpatients of general practice department were discharged with improvement or cure;the other outcomes included transferred to specialist departments （6.1%）,referred to higher level hospitals （2.8%）,auto-discharge （0.9%） and death （0.1%）.Conclusions The disease profile of inpatients in department of general practice in Grade A hospital includes undifferentiated disease,common diseases,frequently encountered diseases and chronic diseases of all systems,multiple diseases are common,which is similar with the disease profile of community health service center.It＆#39;s suggesting that general practice department in Grade A tertiary hospital can make up for the shortage of specialist departments and meet the basic medical needs of patients.