Objective To provide baseline date for further research by retrospectively investigating the disease constitution of over-60-year old patients in the West China Hospital of Sichuan University in 2011. Methods The information of over-60-year old outpatients was extracted from HIS and their diagnoses were classified by ICD-10. The data of single disease among top 3 categories of diseases were rearranged and analyzed by Excel software. Results The total of over-60-year old outpatients was 895 123 person-time in 2011, accounting for 19.65%, including 716 826 person-time in specialist outpatient clinics. The specialist diagnoses of 683 491 person-time could be classified by ICD-10, accounting for 95.35% of specialist outpatients. The top 12 diseases were neoplasm, circulatory, digestive, factors influencing health status and contacting with health services, respiratory, musculoskeletal system and connective tissues, nervous, eyes, symptoms/signs and abnormal clinical and laboratory findings, non-classified, mental and behavioral disorders, endocrine, and genitourinary system diseases, and the cumulative constituent ratio was 92.96%. The main pathogenic sites of neoplasm were bronchus and lung (21.98%), esophagus (8.66%), stomach (8.10%), rectum (7.37%), prostate (5.86%), and liver and intrahepatic bile ducts (5.55%), with a cumulative constituent ratio of 57.72%. The main disease burden in circulatory system was hypertension (39.50%), chronic ischaemic heart disease (11.17%), and cerebral infarction (9.70%), and the cumulative constituent ratio was 60.38%. While the main disease burden in digestive system was gastritis and duodenitis (24.98%), other diseases of digestive system (9.26%), and other diseases of liver (8.90%), and the cumulative constituent ratio was 43.13%. There were more female than male among the over-60-year old outpatients (50.67% vs. 49.33%), and male was higher than female only in the incidence of neoplasm, respiratory, factors influencing health status and contacting with health services, and genitourinary system diseases. The disease constitution ratio of 60-69 years old patients was 58.21%. The top 3 neoplasm were the malignant tumors in digestive (38.20%), respiratory and intrathoracic organs (24.70%), and lymphoid, haematopoietic and related tissue (11.97%), with a cumulative constituent ratio of 74.87%. Conclusion The top 3 disease burden of over-60-year old outpatients in West China Hospital were neoplasm, circulatory and digestive diseases, which reflects the trend and law of treatment demands of old patients. It needs to deeply analyze the frequency and flow pattern of patients, and to provide evidence for preventing and treating geriatric diseases.
Objective To retrospectively investigate the disease constitution of no less than 60-year-old inpatients in the West China Hospital of Sichuan University in 2011, and to compare with the outpatients in the corresponding period, so as to provide baseline data for further study. Methods The inpatients’ information in 2011 was collected from hospital information system (HIS). The diseases were classified according to ICD-10 based on the first discharge diagnosis. Data rearrangement and analysis were carried out by Microsoft Excel software. Results a) The person time of no less than 60-year-old inpatients were 47 233 in 2011, accounted for 30.35% of all inpatients in the corresponding period. b) The top ten systematic diseases were neoplasm, circulatory, digestive, respiratory, eyes, factors influencing health status and contacting with health services, genitourinary, musculoskeletal system and connective tissue, nervous, and injury, poisoning and other consequences of external causes diseases, respectively. c) The male inpatients were more than the female who suffering from the top ten systematic diseases, except for eyes, musculoskeletal system and connective tissue disease. d) Except for respiratory disease, the number of inpatients who suffered from the other top ten systematic diseases got decreased with age increasing. e) Neoplasm was the most common disease, and the person time of malignant neoplasm inpatients was 10 467 (91.93%). f) The cumulative constituent ratio of the top three malignant neoplasms was 75.43%, including malignant neoplasms of digestive organs, respiratory and intrathoracic organs as well as lymphoid, haematopoietic and related tissues. g) The top five malignant neoplasms of digestive organs accounted for 87.81%, including malignant neoplasms of rectum, stomach, oesophagus, liver and intrahepatic bile ducts as well as colon. h) The bronchus and lung malignant neoplasms accounted for 90.4% of all malignant neoplasms of respiratory and intrathoracic organs inpatients. i) The cumulative constituent ratio of the top four malignant neoplasms of lymphoid, haematopoietic and related tissues was 84.45%, including multiple myeloma and malignant plasma cell neoplasms, other and unspecified types of non-Hodgkin lymphoma, myeloid leukaemia, and diffuse non-Hodgkin lymphoma. Conclusion The male inpatients are more than female in the West China Hospital of Sichuan University in 2011. Most inpatients are at age from 60 to 79 years old. The most common systematic disease is neoplasm, especially the malignant neoplasms with higher constituent ratio, of which the malignant neoplasms of digestive organs, respiratory and intrathoracic organs, and lymphoid, haematopoietic and related tissues were more common than others.
Objective To investigate the orthopaedic inpatients’ disease and cost constitution of the Third People’s Hospital of Chengdu during 2008-2010, so as to provide detailed baseline data for further research on the factorial analysis of disease burden and effective intervention. Methods The medical records of inpatients in orthopaedic department of the hospital during 2008-2010 were collected, and the diseases based on the first diagnosis on discharge records were classified according to the International Classification of Diseases (ICD-10). Results During 2008 to 2010, the total number of inpatients increased year by year. Most of the male inpatients were the young and middle-aged, while the female were the old. The rank order of top 5 systematic diseases didn’t change, while there were 6 single diseases kept ranking as top 10 in those 3 years. The average cost per capita averagely grew by 8.97%. The top 3 constitution of hospitalization cost remained the same, which were material cost, drug cost, and treatment cost; while the top 3 payment modes of hospitalization cost were patient’s own expense, social security, and public expense. Among those payment modes, social security rose obviously, and patient’s own expense reduced generally. Conclusion a) The total number of inpatients increases yearly during 2008-2010, and the gender and age distribution of inpatients are tending towards stability. b) The spectrum of disease and single diseases classified according to the one-level code of ICD-10 are relatively stable in those 3 years; of which the top ranked disease is lumbar disc herniation, and the disease with most obviously rising trend is intertrochanteric fracturethe. c) The hospitalization cost per capita rises year by year, of which the constituent ratio of both material and examination costs grow obviously, but the operation, treatment and bed costs are still lower. It requires a multi-pronged approach to control the increase of hospitalization cost as well as the rationalization of cost constitution. d) Among all payment modes of hospitalization cost, the constituent ratio of patient’s own expense reduces year by year, while social security rises, indicating the medical security in national social security has been further expanded.
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 explore the factors which affect shared decision-making and develop strategies to get patients actively involved in clinical decision-making. Methods We conducted a survey on 566 patients of a Class A Hospital in Sichuan with group random sampling method. The data were collected by the use of anonymous selfadministered questionnaires. We used SPSS 10.0 to analyse the data. Results A total of 600 questionnaires were distributed at random, of which 565 were completed. There were 68% patients who had some knowledge of the disease, and 93% who were willing to participate in clinical decision-making. The patients’ biggest concerns were: treatment effect, cost and doctors’ skills. The biggest difficulties that patients worried about were: long-time waiting in out-patient departments and limited time to communicate with doctors. Conclusion As more and more patients would like to involve in shared decision-making, doctors need to provide patients with more choices and help them make a right decision in their treatment.
To attend the Patient Safety Summit of UK Presidency of the EU 2005, learn and share ideas with each other, participate in discussing and developing the vision and mission as well as goals for patients for patient safety program, seek the common interest for further cooperation so as to help promote the activities on patient safety in healthcare in China.
Participating in patients for patient safety program will help place patients at the center of efforts to improve patient safety. This paper presented a brief introduction to patients for patient safety program and its significance and functions.
Objective To investigate and assess the current status of communication between medical students and old patients so as to improve the communication skills of medical students. Methods A total of 90 medical students were surveyed by a questionnaire. Data analysis was performed with SPSS 13.0 software. Results Medical students have recognized the importance of communication with patients, but they rarely had active communication behaviors. In addition, their knowledge of communication skills was utterly inadequate. Conclusion It is necessary to strengthen the training of communication skills among medical students.
目的 了解住院患者疼痛控制结局的现状及对疼痛控制的满意度，为疼痛管理提供依据。 方法 2012年5月运用便利抽样法选取206例住院患者为研究对象，采用调查问卷的方式了解患者疼痛管理现状和满意度。调查工具为自行设计的患者基本信息调查表、美国疼痛协会结局问卷修订量表。 结果 调查对象当前、过去24 h内最剧烈的疼痛程度及疼痛平均水平以轻度为主，分别占43.2%、42.2%、40.3%；疼痛对一般活动、情绪和其他康复活动的影响程度以中度为主，分别占52.4%、58.3%、53.4%；对疼痛处理结果的满意度以一般为主，占40.8%；78.6%的患者在入院时未被告知疼痛治疗的重要性；66.5%～84.5%的患者对疼痛和止痛药的认知均较差。 结论 二级医院住院患者的疼痛程度较轻，其对生活影响程度尚不严重，但患者对疼痛控制的满意度欠佳，对疼痛相关知识的认知也较差，急需医护人员采取相应的措施提高疼痛控制的效果和质量，从而提高患者在住院期间的满意度。