老年外籍就诊患者的人口学特征和疾病谱分析

Analysis of demographic characteristics and disease spectra in elderly patients with foreign nationals

目的了解老年外籍就诊患者的人口学特征、疾病谱和就诊需求等医疗信息,为推动精准化的国际医疗服务提供科学依据和建议。方法回顾性收集宁波市第一医院近3年期间就诊的所有外籍患者共1 500例,并根据年龄段将患者分为老年组602例和中年对照组898例,对入组患者进行人口学及临床就诊信息的统计和比较。结果老年外籍就诊人群主要来自欧洲(40.5%、244/602),其次分别为北美洲(27.9%、168/602)、亚洲(14.5%、87/602)和非洲(11.0%、66/602),而中年组主要来自亚洲(35.9%、322/898)。两组患者前5位从事的职业相同,分别为教师、经理高管、经商商人、工程师和公司职员。老年外籍患者就诊的前5位疾病种类分别为循环系统疾病、呼吸系统疾病、泌尿生殖系统疾病、消化系统疾病、皮肤疾病。与中年组住院率2.4%(22/898)、持医疗保险率65.6%(589/898)、慢性疾病患病率15.9%(143/898)比较,老年外籍就诊患者住院率高、持医疗保险率低以及慢性疾病患病率明显升高,分别为4.7%(28/602)、56.8%(342/602)、29.6%(178/602)(χ^2=5.420、11.799、39.886,P=0.020、0.001、0.000)。结论本研究的抽样数据统计反映了宁波和沿海地区的外籍中老年人群的地域来源广泛和从事职业较为集中,并具有特征性的疾病谱和诊疗需求,这些人口学和临床特征分析有助于涉外医疗政策的制定和更有针对性地开展优质国际医疗服务。

Objective To investigate the demographic characteristics,disease spectrum and medical needs in elderly patients with foreign nationals(FN),and to provide the scientific evidence for promoting precision international medical services.Methods A total of 1500 patients with foreign nationals visiting at our clinics of Ningbo First Hospital from July 2016 to June 2019 were divided into the edderly group(n=602)and the middle-aged group(as controls,n=898)in this retrospective study.The demographic characteristics and disease spectra were analyzed and compared between the two groups.Results Elderly patients with FN were mainly from Europe(40.5%,244/602),followed by North America(27.9%,168/602),Asia(14.5%,87/602)and Africa(11.0%,66/602),while patients in the middle-aged group mainly came from Asia(35.9%,322/898).The top five occupations in the two groups were at the same,including teachers,senior managers,businessmen,engineers,and company staffs.The top five categories of diseases seen in elderly patients with FN were diseases of the circulatory system,the respiratory system,the genitourinary system,the digestive system and the skin.Compared with the middle-aged group,the elderly group had a higher hospitalization rate(4.7%or 28/602 vs.2.4%or 22/898),lower rate of health insurance coverage(56.8%or 342/602 vs.65.6%or 589/898)and higher prevalence of chronic diseases(29.6%or 178/602 vs.15.9%or 143/898)(χ^2=5.420,11.799 and 39.886,P=0.020,0.001 and 0.000,respectively).Conclusions The statistics of sampling data in the study reflects that the middle-aged and elderly population with FN in Ningbo and coastal areas have a wide range of geographical sources and concentrated occupations,and manifest a characteristic disease spectrum and treatment needs.Analysis of these demographic and clinical characteristics is helpful for formulating the foreign medical policy and developing more targeted deployment of the qualified international medical services.