应用中断时间序列分析评价新型冠状病毒肺炎疫情对北京儿童医院内分泌科门诊量的影响

Application of Interruption-time Series Analysis to Evaluate the Impact of COVID-19 on the Quantity of Outpatient of Endocrinology Department in Beijing Children′s Hospital

目的评价新型冠状病毒肺炎疫情对北京儿童医院内分泌科门诊量的影响。方法收集2017~2021年北京儿童医院内分泌科共计60个月的门诊量数据,包含糖尿病门诊、矮小门诊、甲状腺门诊、性腺门诊及内分泌综合门诊。采用中断时间序列法(interrupted time series,ITS)分析上述记录的变化趋势。结果2019年内分泌总门诊量初始水平为3619人次,疫情暴发后,门诊量即刻下降了1616人次(P=0.005)。在疫情常态化期间,长期趋势的变化量表现为每月上升140人次(P=0.001),较疫情发生前升高了125人次(P=0.003)。内分泌科总门诊人次、内分泌综合专业门诊量、矮小专业门诊、糖尿病专业门诊、甲状腺专业门诊、性腺专业门诊量的斜率改变量分别为125.292、88.111、30.633、7.868、-0.870、-0.451,P值分别为0.003、0.005、0.000、0.015、0.622、0.732,内分泌总门诊量、内分泌综合专业门诊量、矮小专业门诊量、糖尿病专业门诊量在疫情发生后斜率改变量差异有统计学意义,其中内分泌总门诊、综合专业、矮小专业、糖尿病专业较前期增长趋势更快,尤其是矮小专业每月增长率变化最为明显。结论新型冠状病毒肺炎疫情对北京儿童医院内分泌科门诊量影响较大,说明新型冠状病毒肺炎疫情影响了该院内分泌患儿的就诊需求。疫情常态化期间存在明显的门诊量反弹期,对该院的医疗资源分配及疫情防控工作提出了新的挑战。

Objective To evaluate the effect of COVID-19 on the quantity of outpatient of endocrinology department in Beijing Children′s Hospital,Capital Medical University.Methods The data of outpatient volume in the department of endocrinology of a 3A pediatric hospital for 60months were collected,including diabetes clinic,short stature clinic,thyroid clinic,gonad clinic and endocrine clinic.The method of interrupted time series was applied to analyze the trends of those records.Results In 2019,the initial level of endocrinology outpatient service was 3619.After outbreaks,the outpatient volume decreased by 1616 immediately(P=0.005).During the normalization period of the epidemic,the change of the long-term trend showed that the number of people increased by 140 per month(P=0.001),which was 125 times higher than that before the epidemic(P=0.003).The slope change rates of the total number of endocrinology clinics,comprehensive endocrinology clinics,short stature clinics,diabetes clinics,thyroid clinics,gonads clinics outpatients were 125.292,88.111,30.633,7.868,-0.870,-0.451 respectively(P=0.003,0.005,0.000,0.015,0.622,0.732).The slope changes of total endocrinology outpatient visits,short stature outpatient visits and diabetes outpatient visits after the epidemic were statistically significant,among them,the total outpatient department of endocrinology,the general clinic,the short stature clinic and the diabetes clinic were faster than the previous ones,especially the monthly growth rate of the dwarf clinic was the most obvious.Conclusion COVID-19 had a significant impact on the number of outpatient visits to the endocrinology department of the hospital,indicating that COVID-19 affected the needs of children with endocrinology in the hospital.During the normalization of the epidemic situation,there was an obvious rebound period of outpatient volume,which posed new challenges to the medical resource allocation and epidemic prevention and control of our hospital.