2007～2016年深圳市坪山区医院内科住院病人疾病谱、死亡及转诊情况调查

Survey on disease spectrum,death and referral situation of inpatients in Pingshan district people's hospital,Shenzhen city,2007-2016

目的了解深圳市坪山区人民医院近十年内科住院病人疾病谱、病死率、转诊情况的特点及变化规律,为医院建设和学科发展提供依据。方法提取该院内科2007～2016年所有出院病人的病案首页资料,进行回顾性调查。结果住院病人疾病顺位总体变化不大,2016年与2007年相比,疾病构成比上升最多的是内分泌营养代谢疾病(9.28%vs4.92%),构成比下降最多的是传染病(4.51%vs 7.95%)。内科住院病人共死亡310例,病死率1.76%,对比2007～2011年与2012～2016年无显著性差异(P>0.50);死因构成顺位前3位:心脑血管病、恶性肿瘤、呼吸系统疾病。医嘱转院595例,转诊率3.38%,前后5年对比转诊率上升,有显著性差异(P <0.01);同期非医嘱出院4 055例,非医嘱出院率23.05%。结论该院内科住院病人构成与省内外大多医院有所不同,病人增长较快、病死率高、转诊率高、非医嘱离院率高。

Objective To analyze the characteristics and changing rules of disease spectrum,fatality rate and referral rate of medical inpatients in the hospital in the last ten years,so as to provide evidences for hospital construction and discipline development. Methods The data in the first page of the medical records of discharged medical inpatients in the hospital from 2007 to 2016 was extracted and investigated retrospectively. Results There was overall no change in the disease sequence of the hospitalized patients.In the disease composition ratio,the proportion of endocrine nutrition metabolic disease of 2012-2016 increased most compared to the period of 2007-2011（9.28%vs 4.92%）,and that declined most was infectious disease（4.51% vs 7.95%）.There were 310 cases of medical inpatient deaths,and the death rate was1.76%.There was no significant difference in the death rate between 2007-2011 and 2012-2016（P 〉0.50）;The top three diseases causes of death were cardiovascular diseases,malignant tumors,respiratory diseases.There were 595 referral cases with doctors＇ orders,with referral rate of 3.38%.The referral rate of 2012-2016 was significant higher than it of 2007-2011（P 〈0.01）.During 2007-2016,there were 4 055 patients discharged from the hospital,and the discharge rate of nondoctor＇s order was 23.05%. Conclusion The disease composition of medical inpatients in the hospital is different from that of most hospitals in and out of the province,with the fast growth amount of medical inpatients,high mortality rate,high referral rate and high discharged rate of non medical advice.