COVID-19疫情对北京市公立医院住院服务量的影响及其恢复情况分析

Analysis of the impacts of COVID-19 pandemic on the inpatients service volume and its recovery needs in Beijing public hospitals

目的:了解COVID-19疫情对北京市公立医院住院服务的影响,为卫生健康管理决策提供参考。方法:采用描述性方法分析2020年上半年北京市公立医院出院量的变化情况,并利用ARIMA乘积季节模型假设未发生COVID-19情况下对2020—2021年的出院量进行预测,通过比较其与实际状态下出院量的差异,评估COVID-19疫情对住院服务的潜在影响。结果:2020年1—6月出院总量较2019年同期减少69.1万人次(48.0%);外地患者出院量较去年同期下降28.2万人次(65.5%),其中循环系统疾病与恶性肿瘤患者出院人次数下降最多。ARIMA模型结果显示,2020年1—6月实际出院总量与外地患者出院量较预测值分别减少77.3万人次(50.8%)与33.2万人次(69.1%),住院服务的恢复压力不断增加。结论:疫情后期北京市住院医疗服务秩序的恢复将面临更为复杂的挑战,建议卫生健康部门充分利用互联网与现代化信息技术手段,在做好常态化防控的同时,重点做好外地患者与重点专科医院的住院需求应对。

Objective:To investigate the impacts of COVID-19 pandemic on inpatient services in Beijing public hospitals in order to provide a statistic basis for decision making on health management.Methods:A descriptive method was used to analyze the changes in number of inpatients in Beijing public hospitals during the period from January to June 2020,and the Multiplicative Season ARIMA(MS-ARIMA)model was applied to predict the number of patients who should be discharged during the period of 2020 and 2021 under the assumption that COVID-19 did not occur.The potential impact for hospitalization was assessed by comparing the gap of actual and predicted values,respectively.Results:The total number of discharged patients and the number of nonlocal patients from January to June 2020 decreased by 691 thousand(48.0%)and 282 thousand(65.5%),respectively,compared with the same period in 2019,among which patients with circulatory diseases-linked and malignant tumor-linked nonlocal patients were more than those linked to other kinds of diseases.The results of the ARIMA model showed the total number of actual discharged patients and the number of nonlocal patients from January to June 2020 decreased by 773 thousand(50.8%)and 332 thousand(69.1%),respectively,compared with the predicted value,and the pressure to restore inpatient services after the COVID-19 pandemic continues to pile up.Conclusion:The restoration of the order of inpatient medical service in Beijing may face more complicated challenges after the total containment of the pandemic.It is suggested that the authorities in health sector should make the best use of the Internet and modern information technology,so as to meet the potential inpatient needs of nonlocal patients and key specialized hospitals while implementing the normal COVID-19 prevention and control measures.