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福建省晋江市2009-2013年恶性肿瘤住院患者统计分析

实用肿瘤杂志 2015年第5期30卷 477-482页

作者：许群英曾献礼吴淑霞黄东昭张玉柱吴伟阳陈清漂晋江市医学会福建晋江362200

目的研究福建省晋江市新农合恶性肿瘤住院患者情况,为指导疾病防治和学科发展建设提供参考。方法对晋江市新农合恶性肿瘤住院患者30 075例次进行统计分析。结果 2009-2013年晋江市新农合恶性肿瘤住院率总体呈快速上升趋势,住院率以年均1... 详细信息

目的研究福建省晋江市新农合恶性肿瘤住院患者情况,为指导疾病防治和学科发展建设提供参考。方法对晋江市新农合恶性肿瘤住院患者30 075例次进行统计分析。结果 2009-2013年晋江市新农合恶性肿瘤住院率总体呈快速上升趋势,住院率以年均11.2%的速度递增,总住院率630.3/10万。2013年男性住院率954.6/10万,女性606.1/10万,男女住院性别比1.7∶1;住院率高峰在70～74岁年龄组。2009-2013年年龄0～95岁,中位年龄55岁,平均年龄54.3岁,其中45～59岁年龄组13 425例次（44.6%）,45～64岁17 348例次（55.7%）,〉60岁老年患者10 558例次（35.1%）。住院患者居第1位的是肺癌,其次是肝癌、食管癌、结直肠癌、胃癌、乳腺癌、淋巴瘤、鼻咽癌、子宫颈癌、白血病,前10种住院疾病占80.6%～84.5%。5年来,在晋江市住院的恶性肿瘤例次23.1%,转外住院例次76.9%,在晋江市治疗的住院总费用为10.8%,转外住院总费用89.2%,转外医疗机构主要集中在泉州、福州、厦门地区。结论晋江市恶性肿瘤住院率呈快速上升趋势,严重影响群众身体健康,要加强恶性肿瘤预防治疗工作,加强晋江市恶性肿瘤医学学科发展。

关键词：肿瘤流行病学住院病人/统计学和数值数据

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Probabilistic linkage of computerized ambulance and inpatient hospital discharge records: A potential tool for evaluation of emergency medical services

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ANNALS OF EMERGENCY MEDICINE 2001年第6期37卷 616-626页

作者： Dean, JM Vernon, DD Cook, L Nechodom, P Reading, J Suruda, A Univ Utah Sch Med Dept Pediat Intermt Injury Control Res Ctr Salt Lake City UT USA Univ Utah Sch Med Dept Family & Prevent Med Intermt Injury Control Res Ctr Salt Lake City UT USA

Study objectives: Emergency medical services (EMS) is an important part of the health care system. The effect of EMS on morbidity, mortality, and costs of illness is difficult to evaluate because hospital information is not available in out-of-hospital databases. We used probabilistic linkage to create such a database from ambulance and inpatient data and demonstrate the potential for linkage to facilitate evaluation of EMS responses resulting in hospital admission. Methods: Statewide ambulance and inpatient hospital discharge records were available for 1994 through 1946. Ambulance records indicating admission to the emergency department or hospital (165,649 records) were linked to inpatient hospital records indicating emergency admission (146,292 records) by using probabilistic linkage. Out-of-hospital data (dispatch code, treatments rendered, and ages), linkage rates, and inpatient data (discharge status, charges, length of stay, and payer category) were analyzed. Results: We linked 24,299 (14.7%) ambulance events to inpatient hospital discharges. If we had used exact linkage methods, we would have only linked 14,621 record pairs, a loss of nearly 40%. linkage rates were relatively constant between years (approximately 15%) but differed by ambulance dispatch codes. Out-of-hospital dispatch codes with high linkage rates included breathing problems (22.6%), chest pain (21.5%), diabetic problems (16.9%), drowning incidents (14.9%), falls (19.2%), strokes (32.8%), and unconsciousness or fainting episodes (16.1%). Linkage to the hospital record provided access to hospital outcome data. Inpatient mortality was 6.8%. Survivors were discharged home (60.7%), transferred to other acute-care facilities (3.6%) or intermediate-care facilities (23.3%), or discharged with home health care provision (4.9%). The median length of stay was 3 days, and median charges were $6,620;total inpatient charges were $286,737,067. Conclusion: Probabilistic linkage enables ambulance and hospita

关键词：救护车/组织和管理数据库管理系统可行性研究卫生服务研究/方法医院收费/统计学和数值数据医院死亡率信息系统/组织和管理住院病人/统计学和数值数据保险健康/统计学和数值数据住院时间/统计学和数值数据病案连锁/方法病案系统计算机化/组织和管理年患病率结果评价(卫生保健) 病人出院/统计学和数值数据病人转诊/统计学和数值数据概率存活率分析犹他/流行病学青少年成年人老年人老年人 80以上儿童儿童学龄前女(雌)性人类婴儿男(雄)性中年人

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Self-destructive acts occurring during medical general hospitalization

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GENERAL HOSPITAL PSYCHIATRY 2000年第2期22卷 115-121页

作者： Hung, CI Liu, CY Liao, MN Chang, YH Yang, YY Yeh, EK Chang Gung Mem Hosp Dept Psychiat Tao Yuan 333 Taiwan Chang Gung Mem Hosp Dept Nursing Tao Yuan 333 Taiwan Natl Taiwan Univ Hosp Dept Psychiat Taipei 100 Taiwan Taipei Med Coll Taipei Taiwan

Although several articles about suicide in general hospitals have been published, the rates of self-destructive individuals among various diseases and departments have not been reported previously. Moreover, self-destructive acts in Chinese general hospital inpatients have been neglected. We retrospectively investigated self-destructive incidents among medical general inpatients. A total of 75 self-destructive incidents, including 15 fatalities, were identified during the 10-year study period. The self-destructive rate was 8.7 per 100,000, and the fatality rate was 1.8 per 100,000 admissions. The highest self-destructive rate occurred in patients admitted to the rehabilitation weird (33.4 per 100,000) followed by the neurology ward (29.9 per 100,000). The highest fatality rate occurred among patients in the neurology ward (6.7 per 100,000). The majority of self-destructive patients suffered from a chronic or terminal illness with the most frequent types of illnesses being malignant neoplasm (31.1%), neurological disease (20.3%), and chronic obstructive pulmonary disease (COPD, 10.8%). COPD patients had the highest rate of self-destructive behavior (64.0 per 100,000) and the highest fatality rate (16.0 per 100,000) due to these incidents. The most common self-destructive incident was knife-cutting More than one-half (53.4%) of the self-destructive incidents occurred within the first 2 weeks of admission, and nearly one-half (46.7%) occurred during the night shift. Moreover, the majority of severe or fatal incidents also occurred during the night shift. The results suggest that close supervision of high-risk patients should be mandatory within the first 2 weeks following admission, especially during the night shift. (C) 2000 Elsevier Science Inc.

关键词：疾病/心理学医院科室/统计学和数值数据医院综合/统计学和数值数据住院病人/心理学住院病人/统计学和数值数据住院时间危险性评估自杀/预防和控制自杀未遂/心理学自杀未遂/统计学和数值数据台湾/流行病学时间因素成年人老年人女(雌)性人类男(雄)性中年人

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Short-term outcomes after percutaneous coronary intervention: Effects of stenting and institutional volume shifts

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AMERICAN HEART JOURNAL 2002年第2期144卷 309-314页

作者： Watanabe, CT Maynard, C Ritchie, JL Univ Washington Dept Med Seattle WA 98195 USA Univ Washington Dept Hlth Sci Seattle WA 98195 USA Hlth Serv Res & Dev Seattle WA USA Dept Vet Affairs Dept Med Seattle WA USA

Background This study examines how the dissemination of stenting and procedural shifts to high-volume facilities have affected short-term outcomes after percutaneous coronary intervention (PCI). Methods Discharge information from the 1994 and 1997 US Nationwide Inpatient Sample was used. Data from 1994 involved 84,036 angioplasties, 27.3% of which were performed for acute myocardial infarction (AMI), at a time when stents were generally unavailable. Data from 1997 included 118,548 angioplasties, 30.2% of which were performed for AMI and 59% of which involved stenting. Outcomes included same-admission mortality and same-admission bypass grafting surgery (CABG). Results Compared with 1994, in 1997 stents were in widespread use, and there was a significant shift in PCI procedures to high-volume facilities. There was no significant difference in overall mortality rates between 1994 and 1997. However, same-admission CABG rates were lower in 1997 than in 1994 for the AMI group (2.9% vs,4.7%, P < .0001) and for the no-AMI group (1.8% vs 3.0%, P < .0001), which was attributable almost entirely to stenting. For 1997 only, patients receiving stents had a lower mortality rate than patients undergoing PCI without stenting (AMI 2.7% vs 4.7%, P < .0001, no AMI 0.7% vs 0.9%, P = .004). Conclusions Despite the dissemination of stenting and shifts to high-volume facilities, overall mortality rates after PCI have not significantly changed. However, patients undergoing stenting in 1997 had a significantly lower mortality rate than patients who did not undergo stenting, suggesting that stents may prevent inhospital deaths. Furthermore, same-admission CABG rates have decreased dramatically, an association seen with the introduction of stenting, but not with volume shifts.

关键词：血管成形术经腔经皮冠状动脉/死亡率冠状动脉分流术/统计学和数值数据医院死亡率/发展趋势住院病人/统计学和数值数据多元分析心肌梗死/流行病学心肌梗死/治疗比值比支架/统计学和数值数据存活率/发展趋势治疗结果美国/流行病学女(雌)性人类男(雄)性中年人

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Patient race and decisions to withhold or withdraw life-sustaining treatments for seriously ill hospitalized adults

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AMERICAN JOURNAL OF MEDICINE 2000年第1期108卷 14-19页

作者： Phillips, RS Hamel, MB Teno, JM Soukup, J Lynn, J Califf, R Vidaillet, H Davis, RB Bellamy, P Goldman, L Beth Israel Deaconess Med Ctr Div Gen Med & Primary Care Dept Med Boston MA 02215 USA Brown Univ Providence RI 02912 USA George Washington Univ Ctr Improve Care Dying Washington DC USA Duke Univ Med Ctr Durham NC USA Marshfield Med Clin Marshfield WI USA Univ Calif Los Angeles Dept Med Los Angeles CA 90024 USA Univ Calif San Francisco Sch Med Dept Med San Francisco CA 94143 USA

PURPOSE: Patient race is associated with decreased resource use for seriously ill hospitalized adults. We studied whether this difference in resource use can be attributed to more frequent or earlier decisions to withhold or withdraw life-sustaining therapies. SUBJECTS AND METHODS: We studied adults with one of nine illnesses that are associated with an average 6-month mortality of 50% who were hospitalized at five geographically diverse teaching hospitals participating In the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). We examined the presence and timing of decisions to withhold or withdraw ventilator support and dialysis, and decisions to withhold surgery. Analyses were adjusted for demographic characteristics, prognosis, severity of illness, function, and patients' preferences for life-extending care. RESULTS: The mean (+/- SD) age of the patients was 63 +/- 16 years;16% were African-American, 44% were women, and 53% survived for 6 months or longer. Of the 9,076 patients, 5,349 (59%) had chart documentation that ventilator support had been considered in the event the patient's condition required such a treatment to sustain life, 2,975 charts (33%) had documentation regarding major surgery, and 1,293 (14%) had documentation of discussions about dialysis. There were no significant differences in the unadjusted rates of decisions to withhold or withdraw treatment among African-Americans compared with non-African-Americans: among African-Americans, 33% had a decision made to withhold or withdraw ventilator support compared with 35% among other patients, 14% had a decision made to withhold major surgery compared with 12% among other patients, and 25% had a decision made to withhold or withdraw dialysis compared with 30% among other patients (P >0.05 for all comparisons). After adjustment For demographic characteristics, prognosis, illness severity, function, and preferences for care, there were no differences in the ti

关键词：非洲裔美国人/统计学和数值数据危重病决策安乐死被动/统计学和数值数据卫生资源/利用住院病人/统计学和数值数据生命支持疗法/利用肾透析/利用呼吸人工/利用危险外科手术/利用美国成年人老年人女(雌)性人类男(雄)性中年人

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Adolescent psychiatric in-patients - A high-risk group for premature death

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BRITISH JOURNAL OF PSYCHIATRY 2000年第2期176卷 121-125页

作者： Kjelsberg, E Ctr Child & Adolescent Psychiat N-0319 Oslo Norway

Background Research has demonstrated increased mortality rates in adolescent psychiatric in-patients. Aims To investigate this excess mortality by calculating standardised mortality ratios (SMRs) relative to cause of death, diagnosis, cohort and age. Method A nationwide Norwegian sample of 1095 former adolescent psychiatric in-patients were followed up 15-33 years after first hospitalisation by record linkage to the National Death Cause Registry Results The SMR was significantly increased for almost all causes of death investigated. In males, all psychiatric diagnoses had significantly increased SMRs, whereas in females, organic mental disorder, anxiety disorder and affective disorder had non-significantly increased SMRs. The SMR was significantly elevated for all age-spans and cohorts investigated. Conclusions Abroad prevention strategy is needed to combat the increased mortality rates found in adolescent psychiatric in-patients. Declaration of interest Funded by a grant from the Foundation for Health and Rehabilitation through the Norwegian Council for Mental Health.

关键词：年龄因素死亡原因队列研究诊断相关患者组/统计学和数值数据住院病人/统计学和数值数据精神障碍/死亡率挪威/流行病学危险因素青少年女(雌)性人类男(雄)性

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我国老年家庭护理成本核算的现状与分析

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中国实用护理杂志 2007年第29期23卷 53-54页

作者：季晓鹏王志红第二军医大学护理系

随着人口老龄化,我国老年医疗护理需求急剧增加。为进一步合理配置老年卫生资源,在相关政策支持下,我国社区卫

关键词：成本及成本分析家庭护理(非专业) 社区卫生服务衰老卫生资源政策制订住院病人/统计学和数值数据住院时间综述老年人人类

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广东省县域内住院率的空间特征及影响因素分析

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现代医药卫生 2018年第4期34卷 490-494页

作者：万东华周舒冬刘子锋赵薇广东药科大学公共卫生学院广东广州510310 中山大学光华口腔医学院附属口腔医院医务科广东广州510060 广东省卫生和计划生育委员会体制改革处广州510060

目的探索广东省58个县及县级市县域内住院率的空间特征及其影响因素,为制定有效措施提高县域内住院率提供参考依据。方法利用2014年广东省58个县及县级市县域内住院率及统计年鉴中的相关指标,采用空间自相关分析及广义估计方程模型来分... 详细信息

目的探索广东省58个县及县级市县域内住院率的空间特征及其影响因素,为制定有效措施提高县域内住院率提供参考依据。方法利用2014年广东省58个县及县级市县域内住院率及统计年鉴中的相关指标,采用空间自相关分析及广义估计方程模型来分析县域内住院率的空间格局和区域差异影响因素。结果广东省58个县及县级市的县域内住院率为80.24%。局部空间自相关分析显示:在西翼出现了高-高聚集,在珠三角出现了一个低-低聚集和一个低-高聚集区域,广义估计方程模型显示人均储蓄存款余额、当地居民到最近三级医院的距离、当地医院服务能力排名及65岁以上所占比例均对县域内住院率有影响(P<0.05)。结论提升县域内住院率是一项系统工程,应根据当前当地的卫生发展状况、社会经济和人口发展特点制定有针对性的卫生发展策略。

关键词：住院病人/统计学和数值数据统计学(主题) 自动数据处理县域内住院率空间自相关广义估计方程影响因素

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探讨老年人自理能力与长期护理的相关性

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中国实用护理杂志 2016年第z1期32卷 -页

作者：王德龄张锋张晓红 200127 上海交通大学医学院附属仁济医院干保老年科 200127 上海交通大学医学院附属仁济医院护理部

目前中国老年人口数量多，增长快，患病率高，住院率上升，高龄老人总数亦呈上升趋势，随着我国医疗水平的上升，越来越多的老年人步入长寿期，越来越多的老人需要被长期照顾。预计2050年，中国60岁及以上老人将达到顶峰，约4.3～4.5亿... 详细信息

目前中国老年人口数量多，增长快，患病率高，住院率上升，高龄老人总数亦呈上升趋势，随着我国医疗水平的上升，越来越多的老年人步入长寿期，越来越多的老人需要被长期照顾。预计2050年，中国60岁及以上老人将达到顶峰，约4.3～4.5亿人，占总人口的1/3，数量将超过发达国家老年人口总和，而亚洲地区的国家老龄化趋势也将在原有基础上增加30%[1]。因此提升老年人自理能力，为老年人提供长期护理显得尤为重要。

关键词：长寿发达国家口腔人口亚洲质量保证卫生保健中国住院病人/统计学和数值数据老年人人类中年人

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User fees and patient behaviour: Evidence from Niamey National Hospital

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HEALTH POLICY AND PLANNING 1995年第4期10卷 350-361页

作者： Weaver, M WASHINGTON UNIV DEPT HLTH SERVSEATTLEWA

Evidence is presented on the effects of price changes on the delay before seeking care and on referral status in a sample of hospital patients in Niger. Price changes are measured as differences across patients at one hospital in whether or not they pay for care, rather than as differences in prices across several hospitals. User fees are charged, but the fee system allows exemptions for some payor categories such as government employees, students, and indigent patients. Evidence is also presented on the effect of income on the delay before seeking care and referral status. The analysis demonstrates a technical point on whether household consumption or current income is a more appropriate measure of income. The analysis shows that user fees affect patient behaviour, but the effects are not the same for outpatients and inpatients. Outpatients who pay for care wait longer before seeking care, but inpatients do not. Inpatients who pay for care are more likely to be referred, but outpatients are not. Patients with more income wait less time to seek care and are less likely to be referred than other patients. Further, household consumption explains patient behaviour better than current income.

关键词：数据收集发展中国家卫生服务易得程度/经济学卫生服务易得程度/统计学和数值数据卫生服务研究/方法医院收费/统计学和数值数据医院公立/经济学医院公立/统计学和数值数据医院公立/利用住院病人/统计学和数值数据最小二乘法分析尼日尔门诊病人/统计学和数值数据病人参与/经济学病人参与/统计学和数值数据转诊和会诊时间因素人类

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