Objective To investigate disease constitution of elderly inpatient in the Xuanwu Hospital, Capital Medical University in Beijing in 2011, so as to provide baseline data for further study. Methods Elderly (patients no less than 60 years old) inpatients’ records in the Xuanwu Hospital, Capital Medical University in 2011 were collected. Based on all the diagnosis on hospital discharge records, the diseases were standardized and classified according to the International Classification of Disease, 10th Edition (ICD-10). Data (including general information of the inpatients, all discharge diagnosis, and the distribution of disease type, age and sex) were analyzed through descriptive analysis using Microsoft Excel 2007 software. SPSS 17.0 software was performed for hypothesis test. Results a) The total numbers of elderly inpatients were 13 807 in 2011, accounting for 39.79% of all the inpatients. Males were more than females (male: female=1.26 to 1). The average kind of disease each patient was diagnosed with was 4.41, ranging from 1 to 11. b) The disease spectrum of patients with one disease was nervous system diseases, neoplasms, and digestive system diseases. The primary and secondary diseases of patients with two diseases were mostly circulatory system diseases. c) All the diagnosis included 18 categories, the top 7 were circulatory system diseases, endocrine, nutritional and metabolic diseases, digestive system diseases, respiratory system diseases, and nervous system diseases, accounting for 83.4% of all the diagnosis. The primary diagnosis included 18 categories, the top 5 were circulatory system diseases, neoplasms, digestive system diseases, respiratory system diseases, and nervous system diseases, accounting for 68.6% of all the elderly inpatients. d) In the circulatory system diseases, the top 5 diseases were cerebral infarction, occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction, angina pectoris, acute myocardial infarction, atherosclerosis, chronic ischaemic heart disease, accounting for 69.8% of all the circulatory system diseases patients. Diseases in different age and gender group were cerebral infarction, angina, acute myocardial infarction, and chronic ischemic heart disease (Plt;0.05). Conclusion The disease constitution of the Xuanwu Hospital, Capital Medical University is complex, and the primary diagnosis is mainly circulatory system diseases. It can be concluded that in the following studies attention should be paid to drug utilization of circulatory system diseases, so as to provide evidence for making the China specific potentially inappropriate medicine list and disease prevention for the elderly.
Objective To investigate the situation of MRI examination in children in outpatient and inpatient departments of the Sichuan Provincial People’s Hospital from 2010 to 2012, so as to provide favourable basis for the choice of imaging examination in children. Methods The materials of electronic reports of MRI examination in paediatric inpatient and outpatient departments from 2010 to 2012 were collected, categorized, and analyzed. Results a) 2 148 children underwent MRI examination in the Sichuan Provincial People’s Hospital from 2010 to 2012. The total number of patients increased with year. Boys were more than girls. The positive incidence was slightly decreased. The number of outpatients was more than inpatients, but the positive incidence was lower in outpatients. b) The total numbers of examination position were increased with year and the number of single position examination was the most (accounted for than 85% of the total numbers). The main examination positions included: head, MRA of the head, cervical column, knees, lumbar column, pituitary gland, thoracic column, and abdomen. The examination positions diversified gradually. The application of examination technique also increased gradually. c) The systemic disease spectrum of positive cases in MRI examination included 9 categories, which accounted for 42.86% of ICD-10. The nervous systematic disease, muscle, skeleton and connective tissue disease were the categories. The major disease types were stable during the recent 3 years. The increase was obvious in injuries of the knees, malacosis and atrophy of the brain, the deformity of the brain. Conclusion The total numbers of the patients and positions examined increased gradually with year in the Sichuan Provincial People’s Hospital from 2010 to 2012. The applications of MRI in the head, limbs and joints, and soft tissues were more extensive. Children diagnosed as positive results had diseases of the central nervous system, limbs and joints, and connective tissue disease.
Abstract Objective To investigate the disease constitution and hospitalization expenses in Songqiao Central Township Health Center (SqC) in Gaoyou City of Jiangsu Province in 2010, so as to provide the baseline data of disease burden for further study. Methods The inpatient records of SqC in 2010 were collected. The first discharge diagnoses were classified according to the International Classification of Disease 10 (ICD-10). The general information of the inpatients, discharge diagnosis, hospitalization expenses, disease category, age, gender, and reimbursement of expenses were described and analyzed by using Microsoft Excel 2003 and SPSS 13.0 software. Results a) The total number of inpatients was 1036 in 2010, and the gender ratio was about 1.0 (50.7% vs. 49.3%); b) The disease spectrum included 17 categories. The cumulative percents of the top 5 systematic diseases were 81.2%, including the respiratory, digestive, neoplasm, circulatory diseases, and injury, poisoning amp; external causes; c) The top 15 diseases were pneumonia, fracture, malignant neoplasm, benign neoplasm, acute bronchitis, cerebral infarction, hypertension, acute appendicitis, emphysema, cholecystolithias accompanied with cholecystitis, inguinal hernia, coronary heart disease, diabetes mellitus, chronic bronchitis and superficial injury; d) The patients suffering from pneumonia and acute bronchitis were mainly over 65 years old and younger than 5; e) The number of chronic diseases significantly increased with age, especially after the age of 35 years old, and reached the peak at the age over 65 years old; while the acute diseases were mainly distributed at the age younger than 15 yeas old and older than 65 years old. The average length of stay, the total hospitalization and out-of-pocket expenses per capita of the chronic diseases were more than those of the acute ones (13.8 days vs. 9.9 days, ? 3 082 vs. ? 2 615; ? 417 vs. ? 371, respectively); f)The length of stay and total hospitalization per capita were quite higher than the other township health centers (11.6 days vs. 5.2 days, ? 3 001.4 vs. ? 1 004.6); and g) Both of the total reimbursement and out-of-pocket expenses per capita accounted for 44%-57% of the total hospitalization expenses. Among the total reimbursement, the payment from New Cooperative Medical Scheme (NCMS) accounted for over 99%, while that from Medical Aid Scheme only accounted for less than 2%. Conclusion a) The top 3 systematic diseases of SqC are seen in respiratory system, digestive system and neoplasm. The acute diseases are mainly pneumonia and fracture; b) The number of acute or chronic diseases increases significantly with age, especially after 35 years old. Both adolescents and the aged suffer from the heaviest burden of diseases; c) The average length of stay and hospitalization expenses pre capita of SqC are much higher than those of the other township health centers; and d) NCMS is the major source of reimbursement. However, the proportion of out-of-pocket expenses and the burden of diseases are still very high and heavy. Thus the policy of NCMS needs to be adjusted step by step in future.
Objective To investigate the disease constitution of Yaqian Township Health Center (YQT) in Xiaoshan District of Zhejiang Province from 2008 to 2010, so as to provide baseline data for further study. Methods Questionnaire and focus interview were carried out to collect inpatients’ case records from 2008 to 2010. The first diagnoses were classified according to ICD-10, and the data of discharge diagnoses were rearranged and analyzed by using Excel 2003 and SPSS 13.0 software. Results a) The total numbers of inpatients were 182, 195 and 248 from 2008 to 2010, respectively; b) The disease spectrum included 9-14 categories, which accounted for 47.6%-66.7% of ICD-10; c) The top 6 systematic diseases accounted for 37.37%-75.39%, which included the circulatory, injury, digestive, respiratory, neoplasms and urinary and reproductive systematic diseases; d) A total of 8 of the top 15 single diseases were the same, including hypertension, great saphenous vein varices, redundant prepuce, lung cancer, fracture, superficial injuries, acute appendicitis, and inguinal hernia; and e) The constitution ratio of the chronic diseases, compared with the acute ones, was higher in 2008, but lower in 2009 and 2010. Conclusion a) In recent three years, the main systematic diseases seen in YQT have been circulatory, injury, digestive, respiratory, neoplasms, and urinary and reproductive systematic diseases. The newly increased diseases in 2010 were pregnancy, childbirth and puerperium. The acute diseases mainly are fracture and injure, while the chronic diseases mostly are hypertension; b) A total of 8 of the top 15 single diseases are the same, indicating the stability of the common inpatients’ diseases; and c) Attention should be paid in future to the chronic diseases management, women’s health and specialized subject construction.
Objective To provide baseline data for further evidence-based evaluation and selection of essential medicine by analyzing the inpatient disease constitution in 8 pilot township health centers located in eastern, central and western China in 2010. Methods The analysis was performed to compare the similarities and differences of both systematic diseases and top 15 single diseases of inpatients in 8 pilot township health centers located in eastern, central and western China in 2010. The Microsoft Excel 2003 and SPSS 13.0 softwares were used for data classification and analysis, and the frequency and composition were used as describing statistical indicators. Results a) The top 5 systematic diseases were respiratory, digestive, circulatory, urinary tract and urogenital systems, as well as the trauma and toxicosis, with accumulative constituent ratio accounting for 71.0%-81.6%; b) The inpatients suffering from top 15 systematic diseases were 10 630, accounting for 61.10%. Each of the respiratory and digestive system contained 6 single diseases including 4 acute and 2 chronic ones, with inpatients accounting for 99.2% and 93.8%, respectively; the circulatory system contained 3 single diseases which were all chronic with inpatient ratio of 84.6%; and c) The chronic diseases were in majority within the top 15 single diseases, which were most commonly seen rather than acute diseases in the pilot township health centers in eastern and central China. The inpatients’ acute diseases were more often seen than chronic diseases in well-off and fundamental township health centers. Conclusion a) The top 5-6 systematic diseases are stable in the pilot township health centers in eastern, central and western China in 2010. The common single inpatient diseases are centralized, which benefits the selection and adjustment of essential medicine for the pilot township health centers in China; b) The capacity building of the western, fundamental and well-off township health centers to diagnose and treat inpatients suffering acute diseases should be promoted; c) The capacity building of the central and general township health centers to diagnose and manage inpatients suffering chronic diseases should be promoted; d) The capacity building of the eastern and well-off township health centers to provide outpatient service should be promoted. The function of the eastern township health centers needs further clarification and improvement; and e) More attention should be paid to diseases prevention, control and treatment for women, children, the elderly and the population with high burden of diseases.
Object To investigate the constitution and expense of inpatient diseases in Jili Community Health Service Center (JCHSC) in Liuyang City of Hunan Province from 2008 to 2010, so as to provide baseline data for further study. Methods The questionnaire was applied and inpatient records in JCHSC between 2008 and 2010 were collected. The diseases were classified and standardized according to the International Classification of Disease, 10th Edition (ICD-10) based on the first diagnosis extracted from discharge records. Such information as general condition, discharge diagnosis and medical expenses etc. were analyzed by using statistic software of Microsoft Excel 2003 and SPSS 13.0. Results a) There were 9 chronic diseases and 6 acute ones among the top 15 single diseases, and both the average hospital stay and per-average hospitalization expense of chronic diseases were higher than those of acute ones (7.8 days vs. 5.6 days; ?2 733 vs. ?1551); b) Per-average expense of drugs as for both acute and chronic diseases accounted for nearly 50% of the total/general expense; c) There were 3 types of treatment models in JCHSC. Model A was only the internal medicine therapy, Model B was internal medicine assisted with surgery, and Model C was surgery assisted with internal medicine therapy; d) In detail, the total per-average expenses in JCHSC between 2008 to 2010 as for each single disease were as follows: coronary heart diseases (CHD, ?2 374 to ?2 680), urinary calculi (?3 268 to ?3 337), chronic bronchitis (?2 452 to ?2 488); e) Per-average hospitalization expenses in internal departments were ?1 719 to ?1 942 for acute diseases and ?2 386 and ?2 523 for chronic ones. Among surgical departments, the per-average hospitalization expenses as for acute diseases and chronic diseases were ?1 438 to ?1 579 and ?3 044 to ?3 607, respectively; and f) The average hospital stay for acute diseases in internal departments were 5.5 to 5.8 days for acute diseases and 6.9 to 7.3 days for chronic ones. By contrast, those in surgical departments were 5.9 to 6.2 days for acute diseases and 8.3 days for chronic ones, respectively. Conclusion a) In JCHSC, a total of 7 inpatient diseases among the top 15 single diseases in 2010 are all chronic with per-average total expense over ?2 000, which is higher than the average level of national CHSC (?2 357.6); b) According to the features of expense constitution models of the inpatient single diseases, the hospitalization expense should be controlled specifically; c) There are 3 kinds of diseases with yearly-increasing per-average total expenses as CHD, hypertension and pulmonary infection during recent 3 years; meanwhile, 4 diseases are with yearly-decreasing per-average total expenses as chronic bronchitis, cholecystolithias or accompanied with cholecystitis, diabetes and inguinal hernia; d) The per-average expenses of chronic diseases in surgical departments are higher than those in internal departments, but those of the acute diseases in surgical departments are lower. Meanwhile, the per-average total expenses as for both chronic and acute diseases in surgical departments present a decline trend year by year. Although the per-average expense on drugs as for both acute and chronic diseases in internal departments show a decline trend, the per-average total expenses indicate an ascending trend; and f) The average hospital stay of chronic diseases is longer than acute ones, while that of the surgical diseases is also longer than internal ones.
Objective To provide baseline datum for further evidence-based selecting essential health technology or essential medicine by comparing the top 15 inpatient diseases in the three pilot township clinics in western China from 2008 to 2010. Methods With the key words as disease spectrum, constitution of disease, inpatient disease category, inpatient diseases and so on, such databases as CBM, CNKI, VIP, WanFang and official websites of Ministry of Health were searched on computer, and the manual search was also conducted in combination to extract the related datum of provinces where the pilot township health centers were situated. The Excel software was used for data classification and analyses. Results (1) Among the 16 included literatures including 15 journal papers and 1 master thesis, 4 scored from zero to 3.5, 9 scored from 3.5 to 6.75, and the left 3 scored 7 or more than 7; (2) The common inpatient diseases in the township health centers in eastern, central and western regions in China were different. The upper respiratory tract infection, acute/chronic bronchitis, acute/chronic gastritis and appendicitis were the common inpatient diseases in the township health centers throughout China. The pneumonia, emphysema, cholelithiasis, cholecystitis, and acute/chronic gastroenteritis were the common inpatient diseases in the township health centers in southwest and northwest regions. The top 15 inpatient diseases in the three pilot township clinics in this study covered all the common inpatient diseases in the township health centers in southwest and northwest regions in China; (3) The total number of the top 15 inpatient diseases of the three pilot township health centers in western China between 2008 and 2010 was 35, including 20 chronic and 15 acute diseases. The chronic diseases were chronic bronchitis, chronic gastritis, hypertension, lumbar/cervical disease, cholelithiasis or cholecystitis, coronary heart disease, chronic pulmonary heart disease, urinary calculi, pelvic inflammation, vertebrobasilar insufficiency, arthritis, acute exacerbation of chronic bronchitis, Meniere’s disease, chronic obstructive emphysema, myocardial ischemia, prostatitis, etc.. The acute diseases were upper respiratory tract infection, pulmonary infection, fracture, superficial injury, acute appendicitis, acute bronchitis, urinary tract infection, acute gastritis, acute gastroenteritis, delivery amp; cesarean section, soft tissue injury, acute urticaria, etc.; and (4) While the common inpatient disease categories were relatively centralized and stable, but some of them were different in regions, inpatients’ age and sex structure. Conclusion (1) There are some differences in the common inpatient diseases in the township health centers among eastern, central and western regions in China, thus it is necessary to select essential health technology and essential medicine according to local conditions; (2) As a good representation, the common inpatients diseases in the three pilot township health centers in western China can provide the baseline evidence for selecting essential health technology and essential medicine for the township health centers in western China; (3) There are lack of national/regional statistics, survey data and evidence-based research on disease spectrum of the township health centers currently. While the investigation methods or statistics measurements/quality of these included studies are variable without standard regulation; and (4) It suggests that the state and every provinces should implement and improve the statistic analysis of disease spectrum of the township health centers, train staffs and fulfill the construction of information system.
Objective To investigate the medication usage in 55 children with urinary tract stones due tomelamine contaminated milk powder who were treated in West China Second University Hospital, Sichuan University werecollected. Methods The hospital’s patient records for the 55 melamine poisoning cases leading to urinary tract stones.Using Assess and excel software to analyze the frequency and sum of drug use, as well the average daily costs and per capitacost for patients. Results For the 55 cases of urinary tract stones, a total of 19 categories and 117 kinds of drugs were used. It was been found that Herba Lysimachiae granules were the most used medicine. The most costly was Cefminox, and finally the drug used in the highest quantity was 0.9 percent sodium chloride injection, the drug cost distribution is unevenness.Conclusions The rationality valuation for children medication lacks of international vulgate index, methodology and needs more basic research. It is worth to study the burden of children with basic disease.
Objective To provide references to control the cost of stroke inpatients by analysing pertinent factors of stroke inpatients. Methods According to the models of Anderson and Newnan, univariable analysis and multivariable statistical analysis were applied to a number of factors including predisposing factors, enabling factors, and needs factors in 1 969 stroke inpatients of two third level first-class hospitals in Chongqing. Results Among the 1 969 stroke inpatients, 64% had a history of hypertension, and 50% exhibited hypertension during their stay in hospital. Expenditure on medication consumed the highest costs (51%). Length of stay was the most important factor affecting inpatient expense, additional factors were number of surgical operation, nurse type, Rankin score, number of complications etc. Conclusions Complex measures focusing on hypertension to prevent and control of stroke are recommended. Reducing unnecessary stay in hospital and appropriate prescribing are important methods to reduce cost of stroke inpatients.
ObjectiveTo explore the appropriate intervention measures to reduce the influence of drug repercussion by pediatric hospital inpatients on nursing work. MethodBetween March 1st and 28th, 2014, statistical analysis on the characteristics of pediatric drug-return by drug repercussion questionnaires was carried out. ResultsEach drug repercussion took much time of the nurses (median of 5.00 minutes per time). The frequency of drug repercussion in the internal medicine department was more than that in the surgical department; the most drug repercussions were found in the respiratory medicine department, reaching 26.84%. The main category of drug repercussion was aerosolized medication (39.32%). The drug repercussion mainly resulted from lack of patients' education and doctor-related administration, which had a proportion of 31.44% and 27.19%, respectively. ConclusionsThe wards which have more drug repercussions should be under the supervision according to the analysis of drug repercussion. Meanwhile, improving patients' education and training of medical staff can reduce the pediatric hospital inpatients' drug repercussion and also may reduce the bad effects on nursing work.