2017年-2020年河南某三甲医院病种结构分析

Statistical Analysis of Disease Structure in a Three A and Tertiary Hospital in Henan Province from 2017 to 2020

目的了解河南某三甲医院住院患者结构及其变化趋势,为加强疾病防治、提高医院管理和服务水平提供科学依据。方法对2017年1月1日-2020年12月31日医院住院病案首页信息进行整理,排除住院费用200元以下的患者信息,共收集到有效数据207631份。2017年1月1日-2018年12月31日未实施DRG相关绩效考核前数据为实施前组,2019年1月1日-2020年12月31日已实施DRGs绩效考核后数据为实施后组。以国际疾病分类编码(ICD-10)为依据,分析4年来患者疾病构成及年龄分布。结果循环、肿瘤、消化系统疾病是医院主要病种,占比稳居2个组前3位,共计77567人,循环系统疾病连续稳居疾病谱第一且增长数量最多,泌尿生殖系统疾病增长比例最明显(增长30.65%),60以上年龄组患者构成比重最大、增幅最快(构成均在35%以上,增长比为16.04%)。结论初步掌握医院病种、疾病、患者年龄的构成特点与形成原因,为医院针对性地进行重点科室建设提供了科学依据,使医院能够针对当前的服务对象,及时地调整医疗服务经营策略,合理地调配有限的医疗卫生资源。

Objectives To investigate the inpatient structure and its changing trend in a Three A and Tertiary hospital in Henan province, and provide scientific basis for strengthening disease prevention and improving hospital management and service level. Methods From January 1 st, 2017 to December 31 st, 2020, the information on the front page of inpatient medical records in the hospital was sorted out, and a total of 207,631 valid data were collected,excluding the information of patients whose hospitalization expenses were less than 200 yuan. Data from January 1 st,2017 to December 31 st, 2018 before DRG performance assessment was not implemented(pre-implementation group), and data from January 1 st,2019 to December 31 st, 2020 after DRGs performance assessment was implemented(post-implementation group). Based on the international Classification of Diseases code(ICD-10), the disease composition and age distribution of patients in the past 4 years were analyzed. Results Diseases of circulatory system, tumor and digestive system were the main diseases in the hospital, accounting for the top 3 of the two groups,with a total of 77567 patients. Diseases of circulatory system ranked the first in the disease spectrum and increased the most, while diseases of genitourinary system increased the most(30.65%). The proportion of patients in the age group above 60 was the largest and the increase rate was the fastest(the proportion was above 35% and the increase ratio was 16.04%). Conclusions A preliminary grasp of the main disease categories, typical diseases, the age of patients and the formation of the characteristics of the formation of the causes, for the hospital to focus on the construction of key departments to provide a scientific basis, so that the hospital could be targeted at the current service object, timely adjustment of medical service management strategy, reasonable allocation of limited medical and health resources.