【摘要】 目的调查成都市第三人民医院骨科2009年住院患者的疾病构成,为进一步研究提供基线数据。方法收集成都市第三人民医院骨科2009年住院患者的病历,按照国际疾病分类(ICD-10)标准对出院记录的第一诊断进行分类整理,然后采用Excel软件进行数据整理和统计分析。结果①该院骨科2009年住院患者共1 220人次,男性多于女性,其疾病谱可分为12类。②前三位住院系统疾病分别是损伤与中毒、肌肉骨骼系统和结缔组织疾患、影响健康状态和与保健机构接触的因素。其中除肌肉骨骼系统和结缔组织疾患外,其余2类系统疾病的住院患者均为男性多于女性。③按照ICD-10标准,损伤与中毒的前九位病种依次为腕和手损伤、髋和大腿损伤、膝与小腿损伤、肩与上臂损伤、下背腰椎骨盆损伤、肘与前臂损伤、胸部损伤、颈部损伤和足踝损伤;在肌肉骨骼系统和结缔组织疾患中的病种依次为背部病、软组织疾患、关节病和骨病软骨病。④在损伤与中毒中排名前五位的单病种依次为腕和手的肌肉肌腱损伤、股骨粗隆间骨折、股骨颈骨折、胫腓骨骨折和腰椎骨折;在影响健康状态和与保健机构接触的因素中,排名前五位的单病种依次为腰椎间盘突出症、脊椎关节强硬、膝关节病、骨质疏松伴病理性骨折和骨坏死。⑤该院骨科2009年人均住院日为23.55天,人均费用为13 073.73元,费用构成包括材料费、药品费(含西药费和中药费)、治疗费(含治疗费和输血费)和手术费(含麻醉费)等。住院费用支付仍以自费为主,社保支付方式占总费用的近一半,公费支付方式仅占总费用不足3%。结论①2009年成都市第三人民医院骨科住院病例中,男性多于女性,且以中、青年为主,而女性以老年为主;主要是损伤与中毒、肌肉骨骼系统和结缔组织疾患、影响健康状态和与保健机构接触的因素三类系统疾病。②2009年该院骨科住院病例前三位的单病种依次为腰椎间盘突出症、腕和手的肌肉肌腱损伤和股骨粗隆间骨折。除腰椎间盘突出症外,其余2类均为男性多于女性。③该院骨科人均住院日为23.55天,费用构成以材料费和药品费为主,共占59.25%,其合理性值得关注。④住院病例费用支付以自费和社保支付方式为主,公费比例较低。更多还原

【Abstract】 Objective To investigate the inpatient’s disease and cost constitution of the Third People’s Hospital of Chengdu in 2009,so as to provide baseline data for further research.Methods The case records of inpatients in the Third People’s Hospital of Chengdu in 2009 were collected,and based on the first diagnose,the diseases were classified according to the International Classification of Diseases(ICD-10).The data including general information of the inpatients,discharge diagnosis and hospitalization expense etc.were rearranged and analyzed using Excel software.Results a) The total number of inpatients was 1220,and male was more than female.The disease spectrum included 12 categories.b) A total of 1093 inpatients suffered from the top 3 systematic diseases as follows: trauma and toxicosis,musculoskeletal system and connective tissue disorders,and the factors affecting health and resulting from contact with health care institutions.Except the musculoskeletal system and connective tissue disorders,the other 2 systematic diseases were mostly seen in male rather than in female.c) According to ICD-10,the top 9 diseases of trauma and toxicosis were injuries to the wrist and hand,injuries to the hip and thigh,injuries to the knee and lower leg,injuries to the shoulder and upper arm,injuries to the lower back,lumbar spine and pelvis,injuries to the elbow and forearm,injuries to the thorax,injuries to the neck and injuries to the ankle and foot;the top 4 diseases in musculoskeletal system and connective tissue disorders were dorsopathies,soft tissue disorders,arthrosis,and osteopathies and chondropathies;among the factors affecting health and resulting from contact with health care institutions,removal of fracture fixation device.d) According to ICD-10(list of three-digit catalogue and four-digit sub-catalogue),the top 5 single diseases in trauma and toxicosis were muscle and tendon injuries of the wrist and hand,intertrochanteric frature,fracture of the femoral neck,fracture of the tibia and fibula,and fracture of the lumbar spine;the top 5 single diseases in musculoskeletal system and connective tissue disorders were lumbar disc herniation,spondylosis,arthrosis of the knee,osteoporosis with pathological fracture,and osteonecrosis.e) The average hospital stay were 23.55 days,and the average cost per capita were 13073.73 yuan which were constituted by material cost,drug cost including western and Chinese medicines,treatment expenses including blood transfusion fee,operation expenses including anesthetic fee,examination expenses including radiation fee and laboratory fee,bed fee and others.The inpatient costs were mainly at patient’s own expense,nearly a half of those expenses were paid by social security,and public medical care only accounted for less than 3% of the total payment.Conclusion In 2009: a) The male inpatients were mainly the young and middle-aged,and the female were the elderly.The main 3 systematic diseases were trauma and toxicosis,musculoskeletal system and connective tissue disorders,and the factors affecting health and resulting from contact with health care institutions.Except the musculoskeletal system and connective tissue disorders,the other 2 systematic diseases were mostly seen in male rather than in female.b) The top 3 single diseases were lumbar disc herniation,muscle and tendon injuries of the wrist and hand,and intertrochanteric fracture.Except lumbar disc herniation,the other 2 single diseases were mostly seen in male rather than in female.c) The average hospital stay was 23.55 days.The overall costs were mainly constituted by material and drug cost(59.25%),with rationality worthy of attention.d) Inpatient costs were mainly at patient’s own expense or paid by social security,and the proportion of public medical care was low in the payment.更多还原