山西省0～14岁因非故意伤害住院儿童疾病负担研究

Disease burden of unintentional injury among children aged 0-14 in Shanxi Province

目的探索山西省0～14岁儿童发生非故意伤害的疾病负担特征,为儿童非故意伤害预防对策的提出提供理论依据。方法选取山西省大同市(北部)、太原市(中部)、运城市(南部)共7所有代表性的三甲医院,整群选取2008—2013年因非故意伤害住院的0～14岁儿童11 034名。通过回顾性查阅电子病历,收集住院儿童的一般情况、非故意伤害类型、转归情况、住院费用及相关费用等相关数据,计算不同人口学特征儿童相应的疾病、经济负担指标。结果不同非故意伤害的转归情况不同,其中交通事故(39.3%)、中毒伤害(25.0%)、跌伤(17.9%)是儿童因伤害致死的前3位原因。2008—2013年所有因非故意伤害住院儿童伤残调整寿命年(disability adjusted life year,DALY)合计为1 024.66人年。不同类型非故意伤害儿童之间的DALY差异有统计学意义(F=2.94,P<0.01),因交通事故住院儿童的DALY(412.64人年)最高。因不同类型非故意伤害住院儿童的住院天数、住院费用之间差异有统计学意义(χ~2/F值分别为3 028.28,48.11,P值均<0.01)。交通事故的人均总经济负担最高,为14 219.40元。结论山西省因非故意伤害住院儿童的疾病、经济负担处于较高水平,交通事故是造成DALY损失及家庭经济负担的首位原因。

Objective To provide a theoretical basis for the prevention of unintentional injuries in children by exploring disease burden of unintentional injuries among children aged 0-14 years in Shanxi Province. Methods 7 representative grade-A tertiary hospital in Datong（ northern）,Taiyuan（ central） and Yuncheng（ southern） of Shanxi Province were selected,and 11 034 hospitalized children caused by unintentional injuries who were aged 0-14 years were selected from 2008 to 2013 by cluster sampling approach. Through electronic medical record,data on gender,household type,age,unintentional injury types,outcomes,hospitalization costs of participants were collected retrospectively. Disability-adjusted Life Year（ DALY） and the economic burden was then calculated. Results Different types of unintentional injuries had different outcomes. Among them,traffic accidents（ 39.3%）,P〈0isoning injuries（ 25.0%） and falls（ 17.9%） were the top three causes of death in children. DALY aggregated from all children admitted in hospital caused by unintentional injuries from 2008 to 2013 was 1 024.66. DALY among children with different unintentional injuries types were statistically significant（ P〈0.01）,with traffic accidents caused the highest DALY（ 412.64）.There were significant differences in hospitalization days and hospitalization costs among different unintentional injuries（ P〈0.01）,and the highest per capita economic burden was 14 219.40 yuan. Conclusion Childhood unintentional injuries contribute to a high share of non-communicable diseases and a high economic burden among children in Shanxi Province,with traffic accidents highest.