2009年青岛市黄岛区伤害住院患者流行特征及其住院费用分析

发布时间：2018-05-06 01:19

本文选题：伤害 + 住院病人　；参考：《山东大学》2011年硕士论文

【摘要】：[研究背景] 伤害是一个严重威胁人群健康的世界性重要公共卫生问题,其发生率高,因急救、康复及早死和残疾而花费巨额费用,造成的经济损失和社会负担远远超过任何一种传染病或慢性非传染疾病。全球疾病负担的研究结果表明,发展中国家的疾病模式正在发生转变,即由传染病为主转为以非传染病和伤害为主。世界多数国家伤害都位于前四位或五位死因。随着我国社会经济的发展,城市化和工业化进程的加快,以及人口数量的增加,伤害的威胁将会呈持续上升的趋势。据推算,我国每年至少有2亿人次发生各种伤害,其中约6000多万人需要急诊就医治疗,1400万人次需要住院治疗,100多万人发生残疾。伤害也是我国1-34岁居民死亡的第一位死因。2005年卫生部通知要求开展全国伤害监测工作,同时印发《全国伤害监测方案》,伤害正式纳入国家疾病控制工作,但是此项监测只是局限于医院门诊伤害监测,不包含伤害住院监测。目前国内对伤害住院的研究也很多,但是未形成一个完整连续全面的监测网络,黄岛区的伤害住院病人的监测2008年前也未开展。山东省自2008年开始在部分县区实施伤害住院的试点工作,黄岛区结合此次试点,建立起覆盖全区的伤害住院监测网络。本次研究的的数据就是来源于此次监测,旨在了解黄岛区的伤害住院的流行特征及医疗负担,为下一步的防治决策提供依据。 [研究目的] 1、分析2009年青岛市黄岛区伤害住院的流行特征及其住院费用,从一定程度上了解伤害疾病负担。 2、为制定有效的伤害干预措施及卫生政策提供科学依据,从而最终达到降低伤害发生、降低医疗负担的目的。 [研究方法] 1、采用山东省疾病预防控制中心慢性病防治所提供的问卷,对因伤害住院病例进行登记。通过对2009年伤害监测资料进行描述性研究分析,了解黄岛区伤害住院的流行病学特征。 2、资料收集：收集全部青岛市黄岛区6家监测医院(二级以上公立医疗机构)2009年伤害住院病例资料,建立SPSS16.0数据库进行分析。 3、人口学资料来源于黄岛区统计局公布的2009年人口数。 [结果] 在1844例符合要求伤害住院患者中,男女比例为3.98：1。伤害发生年龄主要集中在青壮年阶段,其中20-44岁占总报告例数的46.42%。本市/县户籍的占57.01%,本地户籍人口伤害发生率略高于流动人口。伤害发生的时间分布中,主要发生在3-10月(占89.05%),24小时分布高峰时间为上午7点至11点(占50.27%),次高峰时间为13点至20点(占38.34%)。伤害发生地点的年龄分布中除0-4岁年龄组多发生在家中外,其他年龄组人群伤害多发生在公路/街道、工业和建筑场所、家中,分别占46.58%、28.69%、13.29%。发生的主要原因是钝器伤、机动车车祸、跌倒/跌落,分别占33.89%、28.58%、23.81%。其有偿工作人员是伤害发生的高危人群(占49.24%)。伤害发生的原因有性别差异,男性以钝器伤、机动车车祸、跌倒/坠落、刀/锐器伤为主,女性则以机动车车祸、跌倒/坠落、钝器伤、刀/锐器伤、烧烫伤为主。不同年龄组的伤害发生原因分布中,5-14岁年龄组跌倒/依然是主要原因,但发生机动车车祸的比率明显上升,15～64岁年龄组则以钝器伤、跌倒/坠落、机动车车祸、刀/锐器伤为主,65岁以上人群跌倒/坠落、机动车车祸为主。伤害的发生意图类型中,以非故意伤害为主(占81.56%),高文化水平、夏秋季节、晚上是发生故意伤害的相关因素。户籍人群与流动人口在伤害发生的年龄构成、文化程度构成、职业构成、伤害发生时的地点、活动分布上有明显差异；户籍人口较流动人口更容易受到交通事故、烧烫伤的伤害,流动人口更加容易受到钝器伤害；流动人口伤害发生在工业建筑场的人口构成远远高于户籍人口,流动人口伤害发生在家中的比例相对于户籍人口要低很多；户籍人口在体育活动、休闲活动、家务/学习活动中伤害构成高于流动人口。伤害发生的部位主要发生在头面部(占48.10%),上肢(占21.15%),下肢(占18.71%)；伤害的性质主要是是骨折(占33.73%)；不同原因导致伤害的结局中治疗后回家的1700例(占92.19%)；人均住院费用5299.84元,日人均住院费用353.79元,其中机动车车祸导致的人均住院费用为8027.48元,日人均住院费用406.31元。 [结论] 男性青壮年及文化程度偏低人群是伤害干预的重点人群,应重点加强此类人群的安全意识教育及干预。伤害发生主要集中于上下班高峰期的交通伤害及进行有偿作业时的工业建筑场地,因此加强道路交通安全意识教育与工业建筑场地的安全防范是降低意外伤害的重要措施。在进行不同类型伤害预防的时候应根据性别、年龄、户籍、时间、地点、职业的差异区别对待。与其他伤害类型导致的住院费用比较,机动车车祸导致的直接经济负担最沉重；伤害对黄岛区造成的经济负担严重,应采取有效措施加以预防。
[Abstract]:[research background]
Injury is a worldwide important public health problem that seriously threatens the health of the population. It has a high rate of occurrence. It costs huge amounts due to first aid, rehabilitation and early death and disability. The economic loss and social burden are far more than any kind of infectious disease or chronic non communicable disease. The research results of the burden of the whole ball disease indicate that the developing countries The model of the disease is changing, that is, it is mainly from infectious diseases to non infectious diseases and injuries. Most of the countries in the world are in the top four or five causes of death. As China's social and economic development, the accelerated process of urbanization and industrialization, and the increase of population, the threat of injury will continue to rise. It is reckoning that at least 200 million people are injured every year in China, of which about about 60000000 people need emergency medical treatment, 14 million people need hospitalization and about 1000000 people have disabilities. The injury is also the first cause of death of residents aged 1-34 years old in China.2005. The damage monitoring scheme > the injury was formally incorporated into the national disease control work, but this monitoring is limited to the hospital outpatient injury monitoring and does not include injury in hospital monitoring. At present, there are many studies on injury hospitalization in China, but a complete and continuous monitoring network is not formed, and the monitoring of Injury Inpatients in the Huangdao district is also before 2008. It has not been carried out. Shandong province began to carry out the pilot work of injury hospitalization in some counties and districts since 2008. In combination with this pilot, Huangdao district has established a network of injury hospitalization monitoring in the whole area. The data of this study are based on this monitoring, which aims to understand the epidemic characteristics and medical burden of injury in the Huangdao district for the next step. A basis for decision making is provided.
[research purposes]
1, to analyze the epidemiological characteristics and hospitalization expenses of injury hospitalization in Huangdao District of Qingdao in 2009, and to a certain extent, understand the burden of injury diseases.
2, provide scientific basis for formulating effective injury intervention measures and health policies, so as to achieve the goal of reducing injury and reducing medical burden.
[research methods]
1, using the questionnaire provided by the Shandong Center for the prevention and control of disease and prevention, the injury inpatient cases were registered. The epidemiological characteristics of injury hospitalization in Huangdao district were analyzed by descriptive analysis of the injury monitoring data in 2009.
2, data collection: collect all the 6 hospital (level two public medical institutions) in Huangdao District of Qingdao city in 2009, and establish the data of the injury in hospital, and establish the SPSS16.0 database for analysis.
3, demographic data are derived from the 2009 population figures released by the Huangdao Bureau of statistics.
[results]
Among the 1844 hospitalized patients who were in compliance with the required injury, the age of the male and female 3.98:1. injuries was mainly concentrated in the young and middle-aged stages, of which 20-44 years of age accounted for 57.01% of the total number of reports in the city / county, and the incidence of injury in the local population was slightly higher than that of the floating population. The time distribution of the injury occurred mainly in 3-10 months. 89.05%), the peak time of the 24 hour distribution was from 7 to 11 a.m. (50.27%) in the morning, and the peak time was 13 to 20 (38.34%). The age distribution of the occurrence of the injury occurred mostly at home and abroad except for the age group of 0-4, and the injuries of the other age groups were mostly in the road / street, industrial and construction sites, and at home, 46.58%, 28.69%, 13.29, respectively. The main causes were blunt injury, motor vehicle accident, fall / fall, 33.89%, 28.58%, and 23.81%. paid workers were the high-risk groups (49.24%). The causes of injury were gender differences, male blunt injury, motor vehicle accident, fall / fall, knife / sharp injury, and female car accident, fall down. 5-14 year old age group fell / still was the main cause of injury in different age groups, but the ratio of motor vehicle accidents increased significantly. The 15~64 year old age group had blunt injury, fall / fall, motor car accident, knife / sharp injury, and people over 65 years old fell / fall. The main types of motor vehicle accident are the non intentional injury (81.56%), high cultural level, summer and autumn season, and night are the related factors of intentional injury. The population and the floating population are the age composition of the injury, the cultural degree, the occupation, the location of the injury and the distribution of the injury. There are obvious differences. The population of the household register is more prone to traffic accidents, the injury of burn and scald, the floating population is more vulnerable to blunt damage, the population composition of the floating population is far higher than the census register population, and the proportion of the floating population is much lower than that of the household population. The number of injuries was higher than the floating population in sports, leisure activities, housework / learning activities. The injury occurred mainly in the head and face (48.10%), the upper limb (21.15%), and the lower limbs (18.71%); the nature of the injury was mainly fracture (33.73%), and 1700 cases (9) of the outcome of the injury resulted from the treatment of different causes. 2.19%): the per capita hospitalization cost was 5299.84 yuan, and the per capita hospitalization cost was 353.79 yuan per day, of which the per capita hospitalization cost of motor vehicle accident was 8027.48 yuan, and the daily per capita hospital cost was 406.31 yuan.
[Conclusion]
The young men and the people with low education level are the key groups of injury intervention. We should focus on strengthening the safety awareness education and intervention of this kind of people. The injuries mainly focus on the traffic injuries at the rush hour and the industrial construction sites for the paid work. Therefore, the education of road traffic safety awareness and the industrial construction field are strengthened. The safety of the land is an important measure to reduce the accident injury. It should be treated according to gender, age, household registration, time, place, and occupational difference in the prevention of different types of injury. Compared with the cost of hospitalization caused by other types of injury, the direct economic burden caused by motor vehicle accident is the heaviest; the harm to Huangdao district is caused by injury. The economic burden is serious. Effective measures should be taken to prevent it.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R181.3

【参考文献】