摘要
目的探讨上海市社区获得性肺炎(CAP)住院患儿的流行病学特征及住院费用情况。方法回顾性病例总结,纳入2018年1月至2020年12月上海市59家医疗机构共63 614例CAP住院患儿为研究对象,采集患儿基本信息、疾病诊断、手术操作和住院费用信息等,并根据来源医疗机构类型分为儿童专科医院组、三级综合性医院组和二级医院组;根据就诊年龄分为<1岁组、1~<3岁组、3~<6岁组、6~<12岁组和12~18岁组;根据疾病严重程度分为重症肺炎组和非重症肺炎组;根据是否接受了手术操作分为手术操作组和无手术操作组。两组间比较采用χ2检验和Wilcoxon秩和检验,多组间比较采用Kruskal-WallisH检验,分析组间CAP住院患儿的流行病学特征和住院费用差异。结果 63 614例CAP住院患儿中男34 243例、女29 371例,就诊年龄为4(2,6)岁,住院时间为6(5,8)d。三级综合性医院组35 331例(55.5%)、二级医院组17 974例(28.3%)、儿童专科医院组10 309例(16.2%)。2018年CAP住院患儿27 943例、2019年29 009例,增长3.8%(1 066/27 943),2020年6 662例,与2018年相比下降76.2%(2 1281/27 943)。儿童专科医院、二级医院和三级综合性医院组收治外省市患儿、重症肺炎比例及住院费用差异均有统计学意义[7 146例(69.3%)比2 202例(12.3%)比9 598例(27.2%)、6 929例(67.2%)比2 270例(12.6%)比9 397例(26.6%)、8 304(6 261,11 219)比1 882(1 304,2 796)比3 195(2 364,4 352)元,χ2=10 462.50、9 702.26、28 037.23,均P<0.001]。2018至2020年CAP住院费用的总额分别为1.1亿、1.3亿、0.4亿元;2018至2020年单次住院费用分别为2 940(1 939,4 438)、3 215(2 126,5 011)和3 673(2 274,6 975)元。<1岁、1~<3岁、3~<6岁、6~<12岁、12~18岁组CAP患儿住院总费用差异有统计学意义[5 941(2 787,9 247)比2 793(1 803,4 336)比3 013(2 070,4 329)比3 473(2 400,5 097)比4 290(2 837,7 314)元,χ2=3 462.39,P<0.001]。重症肺炎组患儿的住院总费用高于非重症肺炎组[5 076(3 250,8 364)�
Objective To investigate the epidemiology and hospitalization costs of pediatric community-acquired pneumonia(CAP)in Shanghai.Methods A retrospective case summary was conducted on 63614 hospitalized children with CAP in 59 public hospitals in Shanghai from January 2018 to December 2020.These children′s medical records,including their basic information,diagnosis,procedures,and costs,were extracted.According to the medical institutions they were admitted,the patients were divided into the children′s hospital group,the tertiary general hospital group and the secondary hospital group;according to the age,they were divided into<1 year old group,1-<3 years old group,3-<6 years old group,6-<12 years old group and 12-18 years old group;according to the CAP severity,they were divided into severe pneumonia group and non-severe pneumonia group;according to whether an operation was conducted,the patients were divided into the operation group and the non-operation group.The epidemiological characteristics and hospitalization costs were compared among the groups.Theχ2 test or Wilcoxon rank sum test was used for the comparisons between two groups as appropriate,and the Kruskal-Wallis H test was conducted for comparisons among multiple groups.Results A total of 63614 hospitalized children with CAP were enrolled,including 34243 males and 29371 females.Their visiting age was 4(2,6)years.The length of stay was 6(5,8)days.There were 17974 cases(28.3%)in the secondary hospital group,35331 cases(55.5%)in the tertiary general hospital group and 10309 cases(16.2%)in the children′s hospital group.Compared with the hospitalizations cases in 2018(27943),the cases in 2019(29009)increased by 3.8%(1066/27943),while sharply declined by 76.2%(21281/27943)in 2020(6662).There were significant differences in the proportion of patients from other provinces and severe pneumonia cases,and the hospitalization costs among the children′s hospital,secondary hospital and tertiary general hospital(7146 cases(69.3%)vs.2202 cases(12.3%)vs.9598 cases
作者
叶颖子
桂永浩
陆权
洪建国
冯瑞
沈兵
张玥杰
董晓艳
苏玲
王晓倩
王佳钰
顾丹萍
徐虹
黄国英
余松轩
张晓波
Ye Yingzi;Gui Yonghao;Lu Quan;Hong Jianguo;Feng Rui;Shen Bing;Zhang Yuejie;Dong Xiaoyan;Su Ling;Wang Xiaoqian;Wang Jiayu;Gu Danping;Xu Hong;Huang Guoying;Yu Songxuan;Zhang Xiaobo(Department of Infectious Diseases,Children′s Hospital of Fudan University,National Children′s Medical Center,Shanghai Pediatric Clinical Quality Control Center,Shanghai 201102,China;Cardiovascular Center,Children′s Hospital of Fudan University,National Children′s Medical Center,Shanghai Pediatric Clinical Quality Control Center,Shanghai 201102,China;Department of Respiratory Disease,Children′s Hospital of Shanghai,Shanghai Jiao Tong University,Shanghai Pediatric Clinical Quality Control Center,Shanghai 200062,China;Department of Pediatrics,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai Pediatric Clinical Quality Control Center,Shanghai 201620,China;Shanghai Key Laboratory of Intelligent Information Processing,School of Computer Science,Fudan University,Shanghai 200433,China;Department of Medical,Shanghai Hospital Development Center,Shanghai 200041,China;Department of Respiratory Disease,Children′s Hospital of Shanghai,Shanghai Jiao Tong University,Shanghai 200062,China;Department of Statistics and Data Management,Children′s Hospital of Fudan University,National Children′s Medical Center,Shanghai 201102,China;Department of Respiratory Medicine,Children′s Hospital of Fudan University,National Children′s Medical Center,Shanghai 201102,China;Cardiovascular Center,Children′s Hospital of Fudan University,National Children′s Medical Center,Shanghai 201102,China;Center for Medical Quality Control Management of Shanghai,Shanghai 200040,China;Department of Nephrology,Children′s Hospital of Fudan University,National Children′s Medical Center,Shanghai Pediatric Clinical Quality Control Center,Shanghai 201102,China;Department of Respiratory Medicine,Children′s Hospital of Fudan University,National Children′s Medical Center,Shanghai Pediatric Clinical Quality Control Center,Shanghai 201102,China)
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2023年第2期146-153,共8页
Chinese Journal of Pediatrics
基金
科技创新2030-“新一代人工智能”重大项目(2021ZD0113501)
人工智能科技支撑专项(21511104502,22511106104)。
关键词
肺炎
儿童
医院费用
Pneumonia
Child
Hospital costs
