新冠疫情前后儿童住院病例疾病谱变化及医院管理应对思考

Changes of Disease Spectrum of Hospitalized Children Before and After the COVID-19 Outbreak and Reflections on Hospital Management

目的:分析新冠疫情前后儿童住院病例疾病谱变化,为儿童疾病预防、儿童医院资源配置及医院精细化管理提供参考依据。方法:回顾性收集2017年至2022年某三甲儿童医院18岁及以下出院患儿病例资料共计455216例,以疫情发生前的2017-2019年为对照组,疫情发生后2020-2022年为研究组,对两组一般情况、疾病顺位等进行分析比较。结果:疫情发生后出院患儿病例较疫情前下降10.34%,病例以1~3岁患儿为主,危重病例和疑难病例、手术操作病例占比上升。儿童住院病例的疾病谱构成较疫情前有差异,但前三位仍为呼吸系统疾病、消化系统疾病、影响健康状况和接触健康服务的因素。呼吸系统疾病构成比下降,主要疾病第一位仍是支气管肺炎,0~<1岁患儿仍以肺炎为主,其余各年龄组以非感染性疾病为首位。结论:新冠疫情发生后,儿童住院病例疾病谱发生了一定变化,疫情相关的防控措施可减少儿童呼吸系统疾病的发生,未来儿童疾病防治工作的重点仍以呼吸系统疾病、消化系统疾病和影响健康状况和接触健康服务的因素为主。儿童医院应结合病种变化适时调整管理策略,促进医院良性发展。

Objective:The purpose of this study was to understand the changes of disease spectrum of hospitalized children before and after the novel coronavirus outbreak,and to provide reference for the prevention of childhood diseases,resource allocation and fine management of children’s hospitals.Methods:A total of 455,216 cases of children aged 18 and below discharged from a grade A ter-tiary children’s hospital from 2017 to 2022 were retrospectively collected.Before the outbreak of the epidemic in 2017-2019,the group was used as the control group,and after the outbreak of the epidemic in 2020-2022,the group was used as the study group.Analyze and compare the general conditions and disease sequence of the two groups.Results:The number of discharged children after the epi-demic dropped by 10.34%compared with before the epidemic.After the outbreak of the epidemic,the majority of discharged children were children aged 1 to 3 years old.The proportion of critical cases,difficult cases,and surgical cases increased.The spectrum of dis-eases in children hospitalized is different from that before the epidemic,but respiratory diseases,digestive diseases and factors affect-ing health status and access to health services are still in the top three.After the epidemic,the proportion of respiratory diseases de-creased,and bronchopneumonia was still the first major disease,and pneumonia was still the main disease in children 0 to less than 1 year old,and non-infectious diseases were the first in other age groups.Conclusion:The disease spectrum of hospitalized children has changed after the epidemic situation.The prevention and control measures related to the epidemic situation can reduce the occurrence of children’s respiratory system diseases,in the future,the prevention and control of childhood diseases will continue to focus on respi-ratory diseases,gastrointestinal disease and factors affecting health status and access to health services.The children’s Hospital should adjust the management strategy according to the change of the disease,and promote the hospital’sbenign development.