新型冠状病毒肺炎疫情对驻京非定点医院呼吸科门诊影响分析

The influence of COVID-19 epidemic on respiratory outpatient department of non-designated hospitals in Beijing

目的分析新型冠状病毒肺炎疫情对非定点医院呼吸科门诊的影响及启示。方法回顾性分析2019-02与2020-02就诊我院呼吸科门诊的就诊人次、就诊病种占比、发热患者占比以及患者影像学检查结果占比进行对比,并进行统计学分析。结果相对于往年同月份门诊数据,疫情期间驻京非定点医院呼吸科门诊病种占比差异显著,急性病与慢性病患者占比相似,就诊人次、发热患者比例明显降低,而胸部CT检查率、肺部CT小结节诊断率、肺恶性肿瘤患者占比明显增高,差异具有统计学意义(P<0.05)。结论医保政策的调整减少了呼吸系统慢性疾病患者的就诊次数,互联网医疗的发展缓解了医院门诊的工作压力,疫情过后会推动医疗服务行业整体格局发生变化,胸部电子计算机断层扫描(Computed Tomography,CT)检查率提高,对于肺癌高危人群肺部小结节诊断率的提高以及肺部早癌的发现具有重要意义,应注意高危人群的长期随访。

Objective To analyze the influence of COVID-19 epidemic on respiratory outpatient department of nondesignated hospital and its enlightenment.Methods Retrospective and comparative analysis was performed on the number of patients,the proportion of diseases,the proportion of patients with fever and imaging results on February 2019 and February 2020 of patients who visited the respiratory outpatient department of our hospital.Results Compared with the outpatient data of the same month in previous years,the proportion of outpatient diseases in the respiratory department of non-designated hospitals in Beijing during the epidemic period was significantly different.The proportion of patients with acute and chronic diseases was similar.The number of visits and the proportion of patients with fever were noticeably reduced,while the rate of chest CT examinations and diagnosis rate of lungs CT nodules and the proportion of patients with lung malignant tumors were remarkably higher,and the difference was statistically significant(P<0.05).Conclusions The adjustment of the medical insurance policy has reduced the number of visits of patients with chronic respiratory diseases,and the development of Internet medical care has eased the work pressure of outpatient clinics in hospitals.After the epidemic,the overall pattern of the medical service industry will change.The increase in the computed tomography(CT)inspection rate of the chest is of great significance for the improvement of the diagnosis rate of small lung nodules in high-risk groups of lung cancer and the detection of early lung cancer.Attention should be paid to long-term follow-up of high-risk groups.