综合性医院全科门诊老年患者就诊情况研究

Features of Elderly Outpatients Seeking Primary Care in the General Hospital

目的了解综合性医院全科门诊老年患者就诊情况。方法选取2016年2月—2017年2月浙江大学医学院附属第一医院电子病历系统中65岁及以上老年人就诊患者1 174人次为研究对象。收集患者的基本情况,包括性别、年龄、就诊时间、诊断;并统计患病的疾病种类与共病情况。结果 1 174人次就诊患者中,诊断≥2种860人次(73.3%)。就诊疾病排在前3位的分别为高血压330人次(28.1%)、糖尿病164人次(14.0%)、慢性胃炎132人次(11.2%)。就诊疾病共病排在前3位的分别为高血压+糖尿病+慢性肾病15人次(2.4%)、高血压+高脂血症+骨质疏松14人次(2.3%)、高血压+高脂血症+前列腺增生13人次(2.1%)。不同性别老年患者高血压、糖尿病、慢性胃炎、睡眠障碍患病率比较,差异无统计学意义(P>0.05);不同季度老年患者高血压、糖尿病、慢性胃炎、睡眠障碍、高脂血症患病率比较,差异无统计学意义(P>0.05)。不同性别老年患者高脂血症患病率比较,差异有统计学意义(P<0.05);不同年龄、诊断老年患者高血压、糖尿病、慢性胃炎、睡眠障碍、高脂血症患病率比较,差异有统计学意义(P<0.05)。结论综合性医院全科门诊老年患者共病较多,以高血压、糖尿病、慢性胃炎较多。

Objective To explore the characteristics of elderly outpatients seeking primary care in the general hospital.Methods Data(including sex,age,consultation time,diagnosis,type of disease,and concomitant diseases)were collected from the electronic medical record system of The First Affiliated Hospital,Zhejiang University,involving 1 174 eligible elderly patients seeking primary care between February 2016 and February 2017.Results Among the elderly outpatients,73.3%(860/1 174)were diagnosed with two or more types of disease.The three diseases owning the highest prevalence were hypertension〔28.1%(330/1 174)〕,diabetes〔14.0%(164/1 174)〕and chronic gastritis〔11.2%(132/1 174)〕.The multimorbidity diseases owning the highest prevalence were hypertension+diabetes+chronic nephropathy〔2.4%(15/613)〕,hypertension+hyperlipidemia+osteoporosis〔2.3%(14/613)〕,hypertension+hyperlipidemia+benign prostatic hyperplasia〔2.1%(13/613)〕.The prevalence of hypertension,diabetes,chronic gastritis and sleep disorder varied significantly by age and diagnosis(P<0.05),but not by sex and quarter(P>0.05).The prevalence of hyperlipidemia differed obviously by sex,age and diagnosis(P<0.05),but not by quarter(P>0.05).Conclusion The prevalence of multimorbidity was high in elderly patients seeking primary care in the general hospital.Moreover,hypertension,diabetes and chronic gastritis were found to have the highest prevalence.