广州市2008-2014年急性呼吸道感染住院病例流行特征和经济负担研究

Epidemic characteristics and economic burden of inpatients with acute respiratory infections in Guangzhou,2008-2014

目的分析2008--2014年广州市急性呼吸道感染（ARI）住院病例的流行特征及直接经济负担。方法选取广州市8个区（县级市）8家大型综合性医院开展ARI住院病例回顾性调查，查询医院电子信息管理系统，收集ARI住院病例的基本信息、诊疗信息、医疗费用等变量信息，按照年份、年龄及病种分层，分析ARI住院病例流行特征及经济负担。结果8家医院共收治ARI住院病例48886例，ARI住院病例数由2008年的5561例增至2014年的8925例。ARI住院病例以0～4岁年龄组占比例最大（占39．4％），其次为〉165岁年龄组（占28．3％）。病例数排在前5位的病种依次为肺炎、急性支气管炎、急性上呼吸道感染、支气管肺炎及急性扁桃体炎，分别占总病例数的36．7％、17．5％、16．8％、16．2％和5．0％。ARI住院病例人均住院费用由2008年的2568．20元增至2014年的6000．90元，年均增长率为15．2％。药费所占比例最大（占38．4％），其次为化验费（占20．6％）。≥65岁年龄组人均住院费用最高，为10625．50元。不同病种中以肺炎病例人均住院费用最高，为7074．70元。结论广州市ARI住院病例数呈上升趋势，0-4和≥65岁年龄组为主要发病人群，住院费用以药费、化验费占比例高，老年肺炎病例在ARI病例所致经济负担中占主导地位。

Objective To investigate the epidemic characteristics and direct economic burden of inpatients with acute respiratory infections （ARI） in Guangzhou from 2008 to 2014. Methods A retro- spective investigation of ARI inpatients was conducted in 8 large-scale general hospitals from 8 districts in Guangzhou. The basic information, diagnosis and treatment information, medical expenses, and other vari- ables were collected by electronic information management systems of the hospitals. Stratified according to years, ages, and diseases, epidemic characteristics and hospitalization expenditure of ARI inpatients were analyzed. Results A total of 48 886 ARI inpatients were treated in the eight hospitals. The number of ARI inpatients increased from 5 561 in 2008 to 8 925 in 2014. Cases aged 4 years or younger accounted for the/argest proportion of the total ARI inpatients ~ 39. 4% ）, followed by cases aged 65 years or older （28.3%）. The top five diseases by cases were pneumonia, acute bronchitis, acute upper respiratory tract infection, bronchial pneumonia, and acute tonsillitis, accounting for 36.7%, 17.5%, 16.8%, 16.2%, and 5.0% of the total cases, respectively. The average medical expenses of the ARI inpatients increased from 2 568.20 Yuan in 2008 to 6 000.90 Xuan in 2014, with an average annual growth rate of 15.2%. Drug cost accounted for the largest proportion （ 38.4% ） of the total expenses, followed by testing cost （ 20.6% ）. The cost of the AR1 inpatients aged 65 years or older was the highest （ 10 625.50 Yuan）. The medical expenses of pneumonia inpatients was the highest （7 074.70 Yuan） among different diseases. Conclusion The number of ARI inpatients was rising in Guangzhou. Cases aged 4 years or younger and 65 years or older were the main groups with higher incidence of diseases. The drug cost and testing cost ac- counted for a higher proportion of the medical expenses. Pneumonia cases in the elderly plays an important role in the economic burden caused by ARI cases.