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 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 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 constitution and financial burden of disease in the West China Hospital of Sichuan University during 2011-2012. MethodsThe data of in-patients (who had been discharged from the department of endocrinology and metabolism or discharged after being transferred to other departments for diagnosis and treatment in the West China Hospital from January 2011 to April 2012) were collected from the Hospital Information System (HIS) of the West China Hospital, including basic information, discharge diagnosis, hospital costs, the information about whether the patients had been registered the insurance in hospital, etc. We classified diseases according to ICD-10 based on each diagnosis when the patients were discharged on the first page of case reports. The data were input using Excel 2010 software, and statistical analysis was performed using SPSS 13.0 software. Resultsa) During 2011-2012, in the department of endocrinology and metabolism, the top five commonly-seen diseases of in-patients were:diabetes, followed by hypothalamic-pituitary-adrenal/gonadal disease, diseases other than endocrine disorders, thyroid disease, and metabolic bone disease. b) The diseases of the top five average hospital stay included:diabetes, followed by malnutrition, metabolic bone disease, diseases other than endocrine disorders, and hypothalamic-pituitary-adrenal/gonadal disease. c) The diseases of the top five total costs of included:diabetes, followed by metabolic bone disease, diseases other than endocrine disorders, malnutrition, and other nutrients deficiency. ConclusionDiabetes and its complications are the major disease as well as the major cause of the burden of disease in the in-patient department of endocrinology and metabolism of the West China Hospital of Sichuan University.
ObjectiveTo analyze disease constitution and cost analysis of inpatients in the department of gynaecology of the Chengdu Women's and Children's Central Hospital in 2013, so as to get known of the patients' demands in diagnosis and treatment, and to provide evidence for further studies. MethodsWe collected information of 5 663 cases through medical records in 2013, standardized disease names according to the WHO international classification of diseases (ICD-10), and classified the kinds of diseases according to the first diagnosis of discharge records. Then we adopted the Excel software for data sorting and statistical analysis. Resultsa) Most of the inpatients were women at childbearing age. The diseases pectrum included 13 categories, with the top 3 systematic diseases including diseases during pregnancy/childbirth and puerperium (50.19%); diseases of the genitourinary system (29.31%), and neoplasms (15.54%). b) According to the ICD-10, the top 5 single diseases during pregnancy/childbirth and puerperium were ectopic pregnancy, abortion, missed abortion, threatened abortion, and hyperemesis during pregnancy; the top 5 single diseases of the genitourinary system were endometrial polyps, ovarian endometriosis cyst, uterine adenomyosis, female secondary infertility, and uterus adhesion; the top 5 single diseases of neoplasms were uterine fibroid, ovarian benign tumour, ovarian teratoma, cervical malignant tumour, and cervical carcinoma in situ. c) The average hospital stay in this department in 2013 were 6.31 days, and the average cost per capita were 6 051.10 yuan, with the top 3 kinds of costs including drugs (28.82%), operation (26.32%), and examination (20.09%). ConclusionMost of the inpatients are women at childbearing age in the department of gynaecology of the Chengdu Women's and Children's Central Hospital in 2013. Ectopic pregnancy, abortion and leiomyoma etc., are commonly-seen in this department. The average hospital stay of the inpatients is relatively short. Drugs and surgeries are main costs during hospitalization. Based on commonly-seen gynaecological disease burden, this hospital should urgently need to reinforce the construction of the specialized subjects, look for their own advantages, increase or adjust manpower, material resources and financial investment according to targets, so as to improve the quality and efficiency of medical service.
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.
Objective To investigate the inpatients disease constitution of the Tibet autonomous region people’s hospital, to provide baseline date for further rational drug use analysis. Methods The medical records of inpatients from 2014 to 2015 were collected from hospital information system. Diseases were classified based on international Classification of Diseases Coding (ICD-10). We analyzed the general situation, main discharge diagnosis and single diseases. Distribution of inpatients frequency, constituent ratio, cumulative frequency of diseases were calculated by Microsoft office 2007. Results (1) A total of 19 177 patients were discharged in 2014, sex ratio (male : female) was 1.07 : 1, involving all 21 system disease of ICD-10; 20 970 inpatients were discharged in 2015, the sex ratio was 1.05 : 1, covering 20 system diseases of ICD-10. (2) The constituent ratio of 3 diseases were over 10%: exogenous injury or poisoning, digestive disease and diseases concerning pregnancy, childbirth and puerperium. (3) The constituent ratio of 5 diseases were between 5% to 10%: respiratory diseases, circulatory system disease, the factors influencing health status and health care institutions contact-tumor morphology, genitourinary system disease, and tumor. (4) In 2014, the top of 10 single diseases based on constituent ratio were singletons natural birth, lung infection, chemotherapy, type 2 diabetes, gallstones with chronic cholecystitis, bronchial pneumonia, gall bladder stones, neonatal aspiration pneumonia, high altitude pulmonary edema, premature rupture of membranes; in 2015, the top 10 main single diseases included singletons natural birth, lung infection, tumor chemotherapy, type 2 diabetes, gallstones with chronic cholecystitis, bronchial pneumonia, cholelithiasis, neonatal aspiration pneumonia, cancer maintenance chemotherapy, iron deficiency anemia. Conclusion The inpatients disease composition of the Tibet autonomous region people’s hospital has certain regional specificity.
Objective To investigate constitution and costs of inpatients with respiratory disease in the Karamay Central Hospital in 2014 and provide baseline data for further evidence-based study. Methods The information of drug use and expenditure of respiratory diseases were collected from the Hospital Information System (HIS). We analyzed the data by Microsoft Excel 2007 software, including the frequency, proportion and cumulative proportion. Results ① A total of 3 306 inpatients with respiratory disease were included, the top three diseases were bronchopneumonia, pneumonia and pulmonary infection, respectively. ② The Han-other people ratio in inpatients with respiratory diseases higher than average ratio in this city, the top three were bronchial asthma (non-severe) (40.21%), bronchopneumonia (38.14%) and acute exacerbation of chronic obstructive pulmonary disease (COPD) (36.27%), respectively. ③ The top three hospital stay and costs per capita were pulmonary infection, COPD and bronchial asthma (non-severe), respectively. Conclusion Bronchopneumonia, pulmonary infection, bronchial asthma and COPD are selected as the priority for evidence-based study.
Objective To investigate inpatients disease constitution, costs and rational drug use in the Karamay Central Hospital in 2014 and provide baseline data for further evidence-based study. Methods The information of disease classification, single disease drug use and expenditure of inpatients in 2014 were collected from the Hospital Information System (HIS) of Karamay Central Hospital. We classified the diseases according to the international classification of diseases coding (ICD-10), and analyzed the data by Microsoft Excel 2007 software including frequency, proportion, cumulative proportion and sample average. Results ① A total of 24 936 inpatients in 2014 were included, with male to female ratio being 0.96 to 1 and minority rate being 22.95%. The top three systematic diseases were respiratory diseases, diseases concerning pregnancy, child birth and puerperium and circulatory system diseases respectively; ② The top three age groups were 25 to 59, ≥60 and 0 to 4 respectively; ③ The top three costs per capita of single disease were pulmonary infectious, tumor chemotherapy and symptomatic treatment respectively; the top three western medicine costs per capita were tumor chemotherapy, symptomatic treatment and pulmonary infection; the top three Chinese medicine costs per capita were chronic kidney disease (CKD), angina and ischemic stroke. Conclusion The single diseases ranking and percentage of inpatients in 2014 of Karamay Central Hospital were different from the disease burden of Xinjiang Uygur Autonomous Region, the country and even the whole world. Based on the above results, the respiratory diseases and circulatory diseases were selected as the systematic evidence-based pharmacy study goal.