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 infertile inpatients hospitalized in Pingjin Hospital in Tianjin from 2008 to 2010, so as to provide baseline data for further research. Methods According to diagnosis criteria of WHO, we collected demographical characteristics, disease cause and cost constitution of infertility inpatients hospitalized in Pingjin Hospital in Tianjin from 2008 to 2010. The data of each patient were input into ACCESS database and SPSS 13.0 was used for statistical analysis. Results a) From 2008 to 2010, there were 1 452 infertile patients from 33 different areas of mainland China, 79.7% of which was from the north of China. b) The mean age was 31.2±4.3 years old. The percentage of patients aged 30 to 34 years accounted for the most (40.3%). Mental laborers (23.3%) were more than physical laborers (7.2%). 36.7% of patients received education from universities and 83.1% of patients had family income ranging from 20,000 yuan to 190,000 yuan. c) The mean age of the first sexual activity was 21.4±2.9 years old. 53.7% of patients had only one sexual partner and most couples had sexual activities twice every week. The mean age of husbands was 32.9±5.5 years old with the highest percentage of 30 to 35 years old (39.2%). The percent of intellectual work of husband was the highest (35.9%). 64.9% of patients had normal semen analysis results and 23.0% never took related examination. d) 29.9% of patients was primary infertility and 70.1% was secondary infertility, of which 57.6% had either induced or medical abortion. The mean duration of infertility was 5.2±3.5 years (range 1 to 21 year). e) 76.3% of infertile patients had pelvic adhesion and 88.6% suffered from tubal disease. Among the tubal infertile patients, 23.6% had uterine disease, 5.2% had ovarian disease, 5.0% had endometriosis, 6.7% had multiple problems, and 4.8% had unexplained infertility. In patients with tubal infertility, the incidence of distal fimbria atresia (45.8%) was higher than that of proximal block (32.9%). 24.7% of patients with fimbria atresia had hydrosalpinx and among of them, 21.1% had no hydrosalpinx. 15.2% had congenital tubal defects. f) The average hospital stay was 10.5 days and the cost was 14 253.3 yuan per person. The percentage of material cost was 29.1% and that of drugs was 18.2%. Conclusion a) The total number of infertile inpatients was 1 452 in gynecology department of Pingjin Hospital of Tianjin from 2008 to 2010. 79.7% of patient was from North China. Most of them were 30 to 34 years old and 44.3% had no job. The percentage of patients had university education and that of low-middle family income was the highest. Sexual activity was relatively traditional. Most husbands were 30 to 35 years old and intellectual workers, and 23.0% of them had never taken an examination of semen analysis. More patients were secondary infertile, and the duration of infertility was 1 to 21 years. b) 76.3% of patients had pelvic adhesion and 88.6% had tubal disease. The incidence of distal tubal fimbria atresia was higher than proximal tubal occlusion. c) The average hospital stay was 10.5 days and the cost was 14 253.3 yuan per person which was further lower than each cycle cost of assisted reproductive technology. The overall costs included materials and drugs (47.3%), which were mainly at patients’ own expense.
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 1 220, and male was more than female. The disease spectrum included 12 categories. b) A total of 1 093 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 13 073.73 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.
ObjectiveTo investigate old (the no less than 60-year-old) inpatient's diseases and cost constitution of a tertiary hospital in West China from 2008 to 2012, so as to provide baseline data for further research. MethodsThe case records of no less than 60-year-old inpatients in the tertiary hospital were collected from 2008 to 2012, 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, length of hospital stay and hospitalization costs, were analyzed using Stata10.0 software. Resultsa) The total number of old inpatients was 109 585, and male (59.57%) was more than female (40.43%). The disease spectrum included 18 categories. The percentage of old inpatients increased from 31.57% (2008) to 34.25% (2010). b) The top three systematic diseases were neoplasms, diseases of the circulatory system and diseases of the digestive; the male inpatients were more than the female; the number of inpatients who suffered from the top three systematic diseases got decreased with age increasing; neoplasm was the most common disease, there were 34 944 malignant neoplasm inpatients. c) The cumulative constituent ratio of the top five malignant neoplasms in male and female inpatients were respectively 62.51% and 49.44%; and the top five malignant neoplasms of male inpatients were malignant neoplasm of bronchus and lung, other medical care for neoplasm, malignant neoplasm of esophagus, malignant neoplasm of stomach and malignant neoplasm of prostate. The top five malignant neoplasms of female inpatients were other medical care for neoplasm, malignant neoplasm of bronchus and lung, malignant neoplasm of breast, malignant neoplasm of stomach and malignant neoplasm of cervix uteri. d) The average length of hospital stay decreased from 14.12 days to 11.00 days since 2008, and the average cost per capita increased from ￥14 044.79 yuan to ￥18 932.81 yuan since 2008. The proportion of drug cost of inpatients hospitalization cost decreased from 47.21% to 42.16% since 2008. ConclusionThe male inpatients are more than female in the tertiary hospital from 2008 to 2012. The most common systematic disease is neoplasm, especially the malignant neoplasms with higher constituent ratio. The top five malignant neoplasms of male inpatients and female are different. The average length of stay in hospitals has declined in five years, however the average cost per capita has increased.
ObjectiveTo investigate the disease spectrum and cost constitution of patients aged over 65 years with respiratory diseases in Sichuan Provincial People's Hospital from 2010 to 2014. MethodsThe inpatients' clinical data and costs were collected from hospital information system. The diseases were classified and the cost constitution were analyzed. The data were analyzed using SPSS 18.0 software. ResultsThe total number of the inpatients aged over 65 years was 17600 from 2010 to 2014, with more males (64.0%) than females (36.0%). The patients aged 76.9 years on average and were mainly in the 65-89 age group which accounted for 94.4%. The patients were mainly distributed in geriatric department, respiratory department and emergency department, accounting for 78.2% of the total. The top three respiratory diseases were pneumonia, chronic obstructive pulmonary disease (COPD) and pulmonary tumor accounting for 86.5% of the total with more males than females. There was an upward trend in the proportion of pulmonary tumor, bronchiectasis and pulmonary tuberculosis, and a downward trend in the proportion of asthma, COPD and pneumothorax. The average length of hospital stay decreased from 17.6 days to 16.0 days since 2010, and the average cost per capita increased from ￥20162.6 yuan to ￥30015.1 yuan since 2010. The proportion of drug cost to inpatients hospitalization cost decreased from 57.2% to 48.8% since 2010. ConclusionsPneumonia, COPD and pulmonary tumor are main respiratory diseases of inpatients over 65 years in Sichuan Provincial People's Hospital from 2010 to 2014. The male inpatients are more than female inpatients. The incidence of pulmonary tumor and pulmonary tuberculosis rises, and of asthma and COPD goes down. The incidence of lung tumor is increasing in younger age groups. The average length of hospital stay and the proportion of drug cost have declined in recent five years, while the average cost per capita has increased.