某三级医院2015—2019年重点疾病住院及死亡情况的变化趋势分析

Analysis on the trend of hospitalization and death of key monitoring diseases in a tertiary hospital from 2015 to 2019

目的分析某医院重点疾病的住院和病死率变化情况,以及急性心肌梗死(AMI)患者院内死亡的影响因素。方法收集某院2015—2019年间18种重点疾病住院患者的病案首页数据,采用趋势性检验分析各病种住院人次和病死率的变化特征,混合效应logistic回归分析AMI患者住院死亡的影响因素。结果2015—2019年,该院重点疾病的住院人数呈逐年增长趋势,年均增长速度9.72%,院内病死率呈下降趋势(趋势χ^2=13.97,P<0.001);AMI患者院内死亡的主要影响因素有纳入临床路径、高龄和病情危重。结论2015年以来,该院重点疾病的医疗服务和质量状况在逐步提升;执行疾病临床路径和加强对高危患者的管理,有利于降低院内病死率,提高医疗质量。

Objective To analyze the changes of hospitalization and mortality of key monitoring diseases in a hospital,and the influencing factors of death of inpatients with acute myocardial infarction(AMI).Methods Data of discharge summary records were collected of patients with 18 key monitoring diseases admitted to a hospital between 2015 and 2019.Trend analysis was used to explore the changes of hospitalization and mortality of diseases,and mixed effect logistic models were used to assess the risk factors of death of AMI inpatients.Results From 2015 to 2019,the number of inpatients with key diseases increased yearly,with an estimated annual percentage change of 9.72%,while the inpatient mortality showed a decreasing trend(χ^2=13.97,P<0.001).The main influencing factors of inpatient death of AMI were clinical pathway,older age and critical illness.Conclusion The capacity and quality of medical service for key diseases in this hospital has gradually improved since 2015.The implementation of clinical pathway and intensive care for high-risk patients can be beneficial to reduce the nosocomial mortality,and improve the medical quality.