摘要
目的用大数据技术探讨急诊途径入院的住院患者疾病谱分布特征,为急诊质控和管理提供参考。方法选取中卫云医疗数据平台网络直报数据中169家综合性医院连续3年(2015至2017年)网络直报《住院患者病案首页(卫计统4-1)》的2692.77万份病案首页数据,调取其中经急诊途径入院患者的首页数据,分析疾病谱及相关特征。结果169家医院中,经急诊途径入院患者共591.81万人次,约占21.98%。急诊入院患者的疾病谱呈现如下特征:①数据量:三级医院急诊入院患者明显多于二级医院,但急诊入院占比二级医院高于三级医院;三级医院急诊入院患者数逐年递增,二级医院呈不稳定趋势;但占总住院比例略呈逐年降低的趋势。②病种数:三级医院和二级医院疾病谱总覆盖率都达到国家标准,急诊收容病种数和占比都略呈减少趋势。③病种系统分布:居前五位依次为循环系统疾病(21.53%),损伤、中毒和外因的某些其他后果(14.27%),呼吸系统疾病(11.70%)、消化系统疾病(10.74%)和妊娠、分娩和产褥期(9.23%)。④重点病种在急诊入院患者的分布:与急诊关联密切的13个重点疾病中,急性心肌梗死、心力衰竭、急性脑卒中、肺炎(成人)、急性胰腺炎都呈逐年上升趋势,半数重点疾病占总住院患者近50%。⑤患者预后:无论二级还是三级医院,急诊入院患者病死率历年都高于总住院患者病死率,三级医院住院患者病死率高于二级医院;从急诊入院患者占同期住院死亡患者之比看,都在50%上下,且二级医院更高。结论三级医院急诊入院患者在数据量、病种数和疾病系统分布方面总体均优于二级医院,三级医院住院患者病死率高于二级医院,从一个方面提示三级医院收治患者更为疑难和严重;二级医院急诊入院患者占同期住院死亡患者之比更高,或提示二级医院对急危重症患者的综合救治能力逊于三级医院。通
Objective In this paper,the distribution characteristics of hospital patients with emergency approach to hospital were discussed with big data technology,which provided the reference for emergency quality control and management.Methods The home data of 26.9277 million hospital medical records (Health system 4-1 )of 169 comprehensive hospitals for 3 years (2015 ~2017)were gathered through the Zhong Wei Yun Medical Data Platform Network.The first page data of patients admitted to the hospital by emergency treatment were collected,and the disease spectrum and related characteristics were analyzed.Results The total number of patients emergency admitted to the hospital was 5.9181 million in the 169 hospitals,accounting for about 21.98%.The spectrum of patients with emergency admission was characterized by the following characteristics:①The amount of data:There were obviously more patients admitted to the tertiary hospital than the secondary hospitals.However,the emergency admission ratio of the secondary hospital,was higher than that in the tertiary hospital.The number of patients with emergency admission to the tertiary hospital was increasing year by year.But the emergency admission ratio in the proportion of total hospitalization of the secondary hospital presented an unstable trend and was slightly decreasing yearly.②Number of diseases:The total coverage of disease spectrum reached the national requirements in the tertiary hospitals and secondary hospitals.The numbers and proportions of emergency treatment were slightly decreasing.③The distribution of disease systems:The top five were circulatory disease (21.53%),some other consequences of injury and poisoning and external causes (14.27%),respiratory disease (11.70%),digestive diseases (10.74%),childbirth and puerperium(9.23%).④The distribution of major diseases in patients with emergency admission:In the 13 major diseases associated with emergency care,acute myocardial infarction,acute stroke,adult pneumonia and acute pancreatitis were increased yearly.Ha
作者
丁滨
戴志强
滕春霞
杜昱蕾
薛峰
陈晓红
王竞
魏凌
魏聪
Ding Bin;Dai Zhi-qiang;Teng Chun-xia;Du Yu-lei;Xue Feng;Chen Xiao-hong;Wang Jing;Wei Ling;Wei Cong(Zhong Wei Yun Institute of Medical Data Analytics & Application Technology, Beijing 100055, China)
出处
《中国急救医学》
CAS
CSCD
北大核心
2019年第2期179-183,共5页
Chinese Journal of Critical Care Medicine
关键词
病案首页
大数据
急诊
疾病谱
流行病学
Hospital medical records
Big data
Emergency
Disease spectrum
Epidemiology
