粤港澳大湾区某三甲医院住院患者电子病历分析

Analysis of electronic medical records of inpatients in a tertiary hospital in the Guangdong-Hong Kong-Macao greater bay area

目的针对粤港澳大湾区某大型综合性三甲医院2015-2021年的所有住院患者的电子病历,进行统计分析,讨论COVID-19疫情造成的影响,并为本地医疗资源的合理配置提供参考依据。方法在医院病案系统提取2015-2021年的所有住院病例共计345855条,以《疾病分类与代码》和《手术、操作分类与代码》为基础,进行描述性统计、区间估计、χ^(2)检验和直线相关分析。结果住院病例规模总体稳定,大部分患者来自本地,男性患者少于女性患者,2020年由于COVID-19疫情影响,住院患者人次与2019年相比下降幅度达23.03%;疾病类别主要为消化系统疾病、循环系统疾病、呼吸系统疾病、肿瘤、泌尿生殖系统疾病和妊娠、分娩和产褥期;呼吸系统疾病和妊娠、分娩和产褥期变化较大,前者2020年相较于2019年降幅达49.36%,后者于2017年到达峰值后逐年下降,2021年总人次不足2017年峰值的一半;住院天数均值由2015年的8.22下降至2021年的7.23,整体而言低于广东省及全国;恶性肿瘤患者住院天数均值明显高于其他类别,2015-2021年的住院天数均值达15.7;手术类别主要为消化系统术、产科操作,产科操作与妊娠、分娩和产褥期有直线相关关系。结论应积极分析电子病历数据,适时调整各学科的资源配置,从而更好地满足群众就医需求;COVID-19疫情于2020年不仅对正常医疗秩序产生了一定冲击,也影响了人们的生活方式,从而改变了疾病谱构成,尤其是呼吸系统疾病,长期影响尚待进一步观察。

Objective To conduct a statistical analysis of electronic medical records of all inpatients from 2015 to 2021 in a large comprehensive tertiary hospital in the Guangdong-Hong Kong-Macao Greater Bay Area.The impact of the COVID-19 pandemic was discussed,and reference data for the rational allocation of local medical resources were provided.Methods A total of 345,855 inpatient cases from 2015 to 2021 were extracted from the hospital’s medical record system.Descriptive statistics,interval estimation,chi-square tests,and linear correlation analyses were conducted based on the International Classification of Diseases and Related Health Problems(ICD)and the International Classification of Procedures in Medicine(ICPM).Results The overall scale of inpatient cases remained stable,with the majority of patients coming from the local area.There were fewer male patients than female patients,and in 2020,due to the impact of the COVID-19 pandemic,the number of inpatients decreased by 23.03%compared to 2019.The main disease categories included digestive system diseases,circulatory system diseases,respiratory system diseases,tumors,genitourinary system diseases,and pregnancy,childbirth,and the puerperium.Respiratory system diseases and pregnancy,childbirth,and the puerperium showed significant changes,with the former experiencing a 49.36%decrease in 2020 compared to 2019,and the latter declining annually after reaching a peak in 2017,with the total number of cases in 2021 being less than half of the peak in 2017.The mean length of hospital stay decreased from 8.22 days in 2015 to 7.23 days in 2021,which was lower than the averages in Guangdong Province and nationwide.The mean length of hospital stay for malignant tumor patients was significantly higher than other categories,reaching 15.7 days from 2015 to 2021.The main surgical categories were digestive system surgeries and obstetric procedures,with obstetric procedures showing a linear correlation with pregnancy,childbirth,and the puerperium.Conclusion Active analysis of electronic medical record data should be conducted to adjust the resource allocation of various disciplines in a timely manner,thereby better meeting the medical needs of the population.The COVID-19 pandemic not only had a certain impact on normal medical order in 2020 but also affected people’s lifestyles,thereby changing the composition of disease spectra,especially respiratory system diseases.Long-term effects remain to be further observed.