某三甲口腔专科医院口腔颌面外科住院常见疾病的分布特征

Distribution Characteristics of Common Diseases in the Oral and Maxillofacial Surgery Department of a Tertiary Dental Specialist Hospital

目的分析口腔颌面外科住院常见病患者性别、年龄、住院天数、医疗付费方式、住院费用的分布特征,为学科建设、疾病防治、医疗费用控制提供参考。方法采用描述性统计、正态性检验对中部地区某三甲口腔专科医院出院时间为2018年1月1日-2022年12月31日、主要诊断国际疾病分类代码在《国家口腔区域医疗中心设置标准》的16类主要常见病、多发病清单内、进行手术治疗的18072份住院病案首页数据进行回顾性分析。结果16类常见口腔颌面外科疾病例数历年以来占全部住院病例的80%以上,结构较稳定;性别方面,总体男性多发于女性(1.16:1),性别比最高为口炎和有关损害2.06:1,最低为颞下颌关节疾患0.25:1;年龄方面,总体跨度在1岁~98岁,集中在17岁~-35岁、46岁~66岁、1岁~11岁3个年龄段,中位数最高为三叉神经疾患65岁(Q158,Q371),最低为腭裂5岁(Q11,Q310);住院天数方面,总体四分位数为7(5,10)天,中位数最高为口腔恶性肿瘤11天(Q18,Q314),最低为腭裂5天(Q14,Q36);医疗付费方式方面,总体使用医保支付患者占比38.9%,口腔原位癌/良性肿瘤等5类疾病使用医保支付患者占比超过50%,牙面畸形(除外颞下颌关节疾患)等5类疾病使用医保支付患者占比低于20%;住院费用方面,总体四分位数为16586.71(12531.28,32718.00)元,平均值为29168.91元,住院费用中间50%病例的费用构成各有特点,13类疾病手术费和材料费构成比超过50%。结论常见口腔颌面外科疾病病种结构稳定;性别、年龄、住院天数、医疗付费方式、住院费用具有聚集性且病种间极具差异;应根据疾病谱变化、病种特点科学进行学科建设,加强超长住院天数、超高住院费用的病例管理,进一步提高医疗质量,减轻患者经济负担。

Objectives This study aims to analyze the distribution characteristics of gender,age,length of stay,medical payment methods,and hospitalization expenses among oral and maxillofacial surgery patients with common diseases,so as to provide a reference for discipline construction,disease prevention and treatment,and medical cost control.Descriptive statistics and normality test were used to retrospectively analyze the front-page data in 18,072medical records that were discharged from a tertiary dental specialty hospital in the central region from January 1,2018 to December 31,2022.These cases had the main diagnosis International Classification of Diseases codes in the list of 16major common diseases and frequently occurring diseases in the"National Oral Regional Medical Center Establishment Standards",and surgical treatment was performed.Results The number of 16 common oral and maxillofacial surgical diseases accounted for more than 80%of all hospitalized cases over the years,and the structure was relatively stable.In terms of gender,it was more common in males than females(1.16:1).The highest sex ratio was 2.06:1 for stomatitis and related injuries.The lowest was 0.25:1 for temporomandibular joint disorders.In terms of age,the overall span was from 1 to 98 years old,concentrated in three age groups of 17 to 35 years old,46 to 66 years old,and 1 to 11 years old.The median was 65 years old for trigeminal neurological disorders(Q158,Q371)and the lowest was 5 years old(Q11,Q310).In terms of length of stay,the overall quartile was 7(5,10)days,with the highest median being 11 days(Q18,Q314)for oral malignant tumors,and the lowest median being 5 days(Q14,Q36)for cleft palate.In terms of medical payment methods,38.9%of patients used medical insurance to pay.More than 50%of patients used medical insurance to pay for five types of diseases such as oral cancer in situ/benign tumors,and less than 20%of patients used medical insurance to pay for five types of diseases including dentofacial deformity(excluding temporomandibular joint disorders).In terms of hospitalization expenses,the overall quartile was 16,586.71 yuan(12531.28,32718.00 yuan),and the average was 29168.91 yuan.The cost composition of the middle 50%of cases with hospitalization expenses had its own characteristics,and the proportion of surgical fees and material fees for 13 types of diseases exceeded 50%.Conclusions Common oral and maxillofacial surgical diseases have stable structure.Gender,age,length of hospitalization,medical payment methods,and hospitalization expenses are clustered and vary greatly among disease types.Discipline construction should be carried out scientifically based on changes in disease spectrum and disease characteristics.Case management of ultra-long hospitalization days and ultra-high hospitalization costs should be strengthened to further improve medical quality and reduce patients'economic burden.