中国全科医学 ›› 2022, Vol. 25 ›› Issue (13): 1582-1588.DOI: 10.12114/j.issn.1007-9572.2022.0134

所属专题: 神经系统疾病最新文章合集

• 论著·人群健康与流行病学研究 • 上一篇    下一篇

2015—2019年江西省出血性脑卒中流行特征及住院费用分析

殷淑娟1,2, 况杰2, 陈积标1,2, 张晓林1,2, 韩梦琦1,2, 吴一帆1,2, 贾伟杰1,2, 易应萍1,*()   

  1. 1.330006 江西省南昌市,南昌大学第二附属医院大数据中心
    2.330006 江西省南昌市,南昌大学公共卫生学院;江西省预防医学重点实验室
  • 收稿日期:2021-10-26 修回日期:2022-03-27 出版日期:2022-04-12 发布日期:2022-04-22
  • 通讯作者: 易应萍
  • 殷淑娟,况杰,陈积标,等. 2015—2019年江西省出血性脑卒中流行特征及住院费用分析[J].中国全科医学,2022,25(13):1582-1588.[www.chinagp.net]
    作者贡献:易应萍提出研究思路,设计研究方案,对文章整体负责、监督管理;张晓林负责研究的实施与可行性分析;陈积标、吴一帆收集数据;贾伟杰整理数据;韩梦琦负责统计分析;殷淑娟撰写论文,进行结果的分析与解释;况杰进行论文的修订。
  • 基金资助:
    国家重点研发计划项目(2020YFC2002901,2018YFC1312902); 国家自然科学基金资助项目(81960609); 江西省研究生创新专项资金(YC2020-S134,YC2021-S199)

Epidemiological Characteristics and Hospitalization Costs of Haemorrhagic Stroke in Jiangxi, 2015—2019

Shujuan YIN1,2, Jie KUANG2, Jibiao CHEN1,2, Xiaolin ZHANG1,2, Mengqi HAN1,2, Yifan WU1,2, Weijie JIA1,2, Yingping YI1,*()   

  1. 1. Big Data Center, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
    2. School of Public Health, Nanchang University/Jiangxi Provincial Key Laboratory of Preventive Medicine of Jiangxi Province, Nanchang 330006, China
  • Received:2021-10-26 Revised:2022-03-27 Published:2022-04-12 Online:2022-04-22
  • Contact: Yingping YI
  • About author:
    YIN S J, KUANG J, CHEN J B, et al. Epidemiological characteristics and hospitalization costs of haemorrhagic stroke in Jiangxi, 2015—2019[J]. Chinese General Practice, 2022, 25 (13) : 1582-1588.

摘要: 背景 我国尚缺乏大样本的出血性脑卒中流行病学调查,江西省脑血管病流行形势严峻。 目的 分析江西省出血性脑卒中住院患者流行特征及住院费用情况,为出血性脑卒中防控提供科学依据。 方法 通过江西省卫生健康委员会信息中心疾病诊断相关分组(DRGs)管理系统,获取江西省2015—2019年出院主诊断为I60~I61〔依据国际疾病分类第10版(ICD-10)标准〕的出血性脑卒中的患者信息,对其流行特征及住院费用进行分析。 结果 2015—2019年江西省出血性脑卒中住院患者总计128 788例,其中脑出血115 254例(89.49%),蛛网膜下腔出血13 534例(10.51%)。2015—2019年江西省出血性脑卒中患者总住院率由64.36/10万升高至86.05/10万,呈上升趋势(χ2趋势=1 144.969,P<0.001);脑出血总住院率由58.96/10万升高至75.22/10万,呈上升趋势(χ2趋势=727.089,P<0.001);蛛网膜下腔出血总住院率由5.41/10万升高至10.83/10万,呈上升趋势(χ2趋势=659.513,P<0.001)。出血性脑卒中患者共病及并发症前5顺位排序为高血压、肺部感染、脑梗死、其他脑血管病、糖尿病。2015—2019年,江西省出血性脑卒中住院患者中位住院时长为14(14)d;患者住院总费用由14 300.61元升高至15 982.47元,不同年份住院患者住院总费用比较,差异有统计学意义(H=834.590,P<0.001)。2017—2019年,药费在住院总费中占比最大,近3年均达35%以上,但3年间比较,差异无统计学意义(H=3.323,P=0.190)。 结论 2015—2019年江西省出血性脑卒中及其亚型患者住院率持续增长,高血压、肺部感染为较常见的共病,住院费用负担仍较重,预防并发症、降低药费可能有助于减轻出血性脑卒中患者的经济负担。

关键词: 出血性卒中, 流行病学研究, 住院费用, 江西

Abstract:

Background

There is no epidemiological survey of hemorrhagic stroke with a large sample size in China. Jiangxi Province faces high and rapidly increased prevalence of cerebrovascular disease in its resident population.

Objective

To understand the epidemiological characteristics and hospitalization costs of hemorrhagic stroke inpatients in Jiangxi, offering a scientific basis for preventing and controlling the disease.

Methods

Through the management system of Diagnosis Related Groups, Informaion Center, Health Commission of Jiangxi Province, the information of patients with a primary diagnosis of hemorrhagic stroke (ICD-10 code I60-I69) discharged during 2015—2019 was collected. Based the data, the epidemiological characteristics and hospitalization costs associated with hemorrhagic stroke were anayzed.

Results

Of the 128 788 cases, 115 254 (89.49%) had cerebral hemorrhage and 13 534 (10.51%) had subarachnoid hemorrhage. During the period, the overall rate of hospitalization attributed to hemorrhagic stroke increased from 64.36/100 000 to 86.05/100 000, showing an upward trend (χ2=1 144.969, P<0.001) . The overall rate of hospitalization attributed to cerebral hemorrhage increased from 58.96/100 000 to 75.22/100 000, demonstrating an upward trend (χ2=727.089, P<0.001) . And the overall rate of hospitalization attributed to subarachnoid hemorrhage increased from 5.41/100 000 to 10.83/100 000, presenting an upward trend (χ2=659.513, P<0.001) . The top five comorbidities and complications of hemorrhagic stroke were hypertension, pulmonary infection, cerebral infarction, other cerebrovascular diseases, and diabetes. The median length of stay for hemorrhagic stroke was 14 (14) days. The median total hospitalization cost increased from 14 300.61 yuan to 15 982.47 yuan, and it varied significantly by year (H=834.590, P<0.001) . Drug cost accounted for the largest proportion of the total hospitalization cost in 2017—2019 (greater than 35% each year) , showing no significant difference across the three years (H=3.323, P=0.190) .

Conclusion

From 2015 to 2019, the rates of hospitalization attributed to hemorrhagic stroke and its two subtypes (cerebral and subarachnoid hemorrhage) demonstrated an upward trend in Jiangxi, with hypertension and lung infection as the most common comorbidities, and relatively heavy burden of hospitalization costs. Reducing the risk of complications and drug cost may contribute to the decrease of financial burden of these patients.

Key words: Hemorrhagic stroke, Epidemiologic studies, Hospitalization costs, Jiangxi