河北省来京患者出院量变化动态分析与预测研究

Analysis and prediction of the changing trend on the number of discharged patients from Hebei Province

目的:了解河北省来京患者出院量变化趋势与规律,为卫生健康管理决策提供参考。方法:采用描述流行病学方法对2009—2018年北京市13家三级医院河北省来京患者出院情况进行分析,并利用ARIMA乘积季节模型对2019、2020年的出院量进行预测。结果:2009—2018年,调查医院河北省患者的出院量逐年增加,由2009年的3383人次增至2018年的68538人次;ARIMA模型结果显示2019、2020年预计将达到71455与75261人次,继续呈上升趋势。月度分布12月、11月与3月出院量较多,2月、10月较少;人群分布男性高于女性,14岁及以下年龄组高于其他年龄组;来源地区多集中在北京周边的保定、廊坊与张家口市,占总数的54%;循环系统疾病远高于其他病种。结论:建议卫生健康部门结合河北来京住院患者变化特征,进一步加快京冀两地区域医疗中心建设,健全住院患者转诊分流制度,积极开展健康宣教,继续推动病历信息共享互通,引导患者合理有序就医。

Objective:To analyze the changing trend and regularity of discharged patients from Hebei province in the central district of Beijing in order to provide a statistic basis for decision making on healthcare management.Methods:This research used the descriptive epidemiological method to analyze the number of outpatients in 13 tertiary hospitals of Beijing from 2009 to 2018,and the Multiplicative Seasonal ARIMA model(MS-ARIMA Model)was applied to predict the discharged patients number in 2019 and 2020,respectively.Results:In central district of Beijing,the number of discharged patients from Hebei province underwent a continuously increasing trend,which rose from 3383 in 2008 to 68538 in 2018.The ARIMA model showed that it will respectively keep increasing up to 71455 in 2019 and 75261 in 2020.From the perspective of time distribution,the number of discharged patients was relatively higher in December,November and March,and it was lower in February and October than in other months.Regarding the distribution of population,the variable“male”showed a higher discharge number than females,and the age group of≤14 years was higher than other age groups in terms of discharged patients.Source areas of patients focused in Baoding,Langfang and Zhangjiakou around Beijing,and the proportion of discharged patients from the above three areas provided up to 54%.In terms of the disease categories,the number of circulatory disease-linked discharged patients was more than that of those linked to other kinds of diseases,which rose up to 16,001 in 2018.Conclusions:The number of discharged patients from Hebei province,especially in tertiary hospitals,that continuously keeps on increasing trend poses a great challenge to the healthcare management in the central district of Beijing.It is suggested that the authorities in health sector should further accelerate the construction of regional medical centers and improve the referral flow of inpatients in Beijing-Hebei region,actively carry out the health education and awareness,and promote the sharing and intercommunications of medical records according to the changing characteristics of inpatients,which could guide patients to seek rationally medical treatment in an orderly manner.