Chinese General Practice ›› 2024, Vol. 27 ›› Issue (11): 1310-1315.DOI: 10.12114/j.issn.1007-9572.2023.0710
• Original Research • Previous Articles Next Articles
Received:
2023-07-24
Revised:
2023-12-11
Published:
2024-04-15
Online:
2024-01-23
Contact:
ZHANG Zhengyi
通讯作者:
张正义
作者简介:
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2023.0710
项目 | 0种慢性病(n=79) | 1种慢性病(n=359) | ≥2种慢性病(n=1 212) | χ2(H)值 | P值 |
---|---|---|---|---|---|
性别[例(%)] | 13.141 | 0.001 | |||
男 | 39(49.4) | 187(52.1) | 745(61.5) | ||
女 | 40(50.6) | 172(47.9) | 467(38.5) | ||
年龄[例(%)] | 13.316 | 0.010 | |||
45~49岁 | 15(19.0) | 96(26.7) | 286(23.6) | ||
50~54岁 | 40(50.6) | 135(37.6) | 413(34.1) | ||
55~59岁 | 24(30.4) | 128(35.7) | 513(42.3) | ||
民族[例(%)] | 17.917 | 0.022 | |||
汉族 | 70(88.6) | 328(91.4) | 1 088(89.8) | ||
回族 | 2(2.5) | 21(5.8) | 63(5.2) | ||
东乡族 | 1(1.3) | 6(1.7) | 26(2.1) | ||
藏族 | 6(7.6) | 2(0.6) | 27(2.2) | ||
其他 | 0 | 2(0.6) | 8(0.8) | ||
职业[例(%)] | 15.155 | 0.019 | |||
在职 | 9(11.4) | 51(14.2) | 212(17.5) | ||
退休或无业 | 5(6.3) | 27(7.5) | 81(6.7) | ||
农民 | 23(29.1) | 80(22.3) | 198(16.3) | ||
其他 | 42(53.2) | 201(56.0) | 721(59.5) | ||
现居地[例(%)] | 5.587 | 0.061 | |||
城镇 | 39(49.4) | 189(52.6) | 708(58.4) | ||
农村 | 40(50.6) | 170(47.3) | 504(41.6) | ||
医疗保险类型[例(%)] | 12.885 | 0.116 | |||
城镇居民医疗保险 | 26(32.9) | 119(33.1) | 402(33.2) | ||
城镇职工医疗保险 | 19(24.1) | 89(24.8) | 353(29.1) | ||
新型农村合作医疗和贫困救助 | 24(30.4) | 96(26.8) | 248(20.5) | ||
全自费 | 6(7.6) | 41(11.4) | 165(13.6) | ||
其他 | 4(5.1) | 14(3.9) | 44(3.6) | ||
入院途径[例(%)] | 13.923 | 0.025 | |||
急诊 | 2(2.5) | 19(5.3) | 84(6.9) | ||
门诊 | 59(74.7) | 264(73.5) | 951(78.5) | ||
其他医疗机构转入 | 18(22.8) | 75(20.9) | 175(14.4) | ||
其他 | 0 | 1(0.3) | 2(0.2) | ||
离院方式[例(%)] | 15.030 | 0.166 | |||
医嘱离院 | 68(86.1) | 325(90.5) | 1 128(93.1) | ||
医嘱转院 | 10(12.7) | 29(8.1) | 67(5.5) | ||
死亡 | 0 | 2(0.6) | 2(0.2) | ||
其他 | 1(1.3) | 3(0.9) | 15(1.3) | ||
住院天数[M(P25,P75),d] | 7(4,9) | 6(4,8) | 6(4,8) | 1.645a | 0.439 |
Table 1 Comparison of general data among middle-aged inpatients with 0,1,or ≥2 chronic diseases
项目 | 0种慢性病(n=79) | 1种慢性病(n=359) | ≥2种慢性病(n=1 212) | χ2(H)值 | P值 |
---|---|---|---|---|---|
性别[例(%)] | 13.141 | 0.001 | |||
男 | 39(49.4) | 187(52.1) | 745(61.5) | ||
女 | 40(50.6) | 172(47.9) | 467(38.5) | ||
年龄[例(%)] | 13.316 | 0.010 | |||
45~49岁 | 15(19.0) | 96(26.7) | 286(23.6) | ||
50~54岁 | 40(50.6) | 135(37.6) | 413(34.1) | ||
55~59岁 | 24(30.4) | 128(35.7) | 513(42.3) | ||
民族[例(%)] | 17.917 | 0.022 | |||
汉族 | 70(88.6) | 328(91.4) | 1 088(89.8) | ||
回族 | 2(2.5) | 21(5.8) | 63(5.2) | ||
东乡族 | 1(1.3) | 6(1.7) | 26(2.1) | ||
藏族 | 6(7.6) | 2(0.6) | 27(2.2) | ||
其他 | 0 | 2(0.6) | 8(0.8) | ||
职业[例(%)] | 15.155 | 0.019 | |||
在职 | 9(11.4) | 51(14.2) | 212(17.5) | ||
退休或无业 | 5(6.3) | 27(7.5) | 81(6.7) | ||
农民 | 23(29.1) | 80(22.3) | 198(16.3) | ||
其他 | 42(53.2) | 201(56.0) | 721(59.5) | ||
现居地[例(%)] | 5.587 | 0.061 | |||
城镇 | 39(49.4) | 189(52.6) | 708(58.4) | ||
农村 | 40(50.6) | 170(47.3) | 504(41.6) | ||
医疗保险类型[例(%)] | 12.885 | 0.116 | |||
城镇居民医疗保险 | 26(32.9) | 119(33.1) | 402(33.2) | ||
城镇职工医疗保险 | 19(24.1) | 89(24.8) | 353(29.1) | ||
新型农村合作医疗和贫困救助 | 24(30.4) | 96(26.8) | 248(20.5) | ||
全自费 | 6(7.6) | 41(11.4) | 165(13.6) | ||
其他 | 4(5.1) | 14(3.9) | 44(3.6) | ||
入院途径[例(%)] | 13.923 | 0.025 | |||
急诊 | 2(2.5) | 19(5.3) | 84(6.9) | ||
门诊 | 59(74.7) | 264(73.5) | 951(78.5) | ||
其他医疗机构转入 | 18(22.8) | 75(20.9) | 175(14.4) | ||
其他 | 0 | 1(0.3) | 2(0.2) | ||
离院方式[例(%)] | 15.030 | 0.166 | |||
医嘱离院 | 68(86.1) | 325(90.5) | 1 128(93.1) | ||
医嘱转院 | 10(12.7) | 29(8.1) | 67(5.5) | ||
死亡 | 0 | 2(0.6) | 2(0.2) | ||
其他 | 1(1.3) | 3(0.9) | 15(1.3) | ||
住院天数[M(P25,P75),d] | 7(4,9) | 6(4,8) | 6(4,8) | 1.645a | 0.439 |
疾病名称 | 例数[例(%)] | 顺位排名 | 平均共病种数( | 顺位排名 |
---|---|---|---|---|
心脏疾病 | 1 091(66.1) | 1 | 2.40±1.00 | 13 |
高血压 | 678(41.1) | 2 | 2.91±0.89 | 8 |
脑血管病 | 342(20.7) | 3 | 3.00±0.95 | 4 |
慢性肺部疾病 | 322(19.5) | 4 | 2.67±0.96 | 10 |
肝脏疾病 | 269(16.3) | 5 | 3.05±0.98 | 3 |
血脂异常 | 256(15.5) | 6 | 2.89±1.00 | 9 |
糖尿病或血糖升高 | 221(13.4) | 7 | 3.13±0.94 | 2 |
胃部或消化系统疾病 | 138(8.4) | 8 | 3.00±0.95 | 4 |
情感及精神方面的问题 | 86(5.2) | 9 | 2.49±0.92 | 12 |
恶性肿瘤 | 75(4.5) | 10 | 1.92±0.85 | 14 |
肾脏疾病 | 71(4.3) | 11 | 3.00±1.00 | 4 |
与记忆相关的疾病 | 31(1.9) | 12 | 3.35±1.20 | 1 |
关节炎或风湿病 | 28(1.7) | 13 | 2.56±1.02 | 11 |
哮喘 | 17(1.0) | 14 | 3.00±1.14 | 4 |
Table 2 Prevalence and comorbidities of 14 chronic diseases in 1 650 middle-aged inpatients
疾病名称 | 例数[例(%)] | 顺位排名 | 平均共病种数( | 顺位排名 |
---|---|---|---|---|
心脏疾病 | 1 091(66.1) | 1 | 2.40±1.00 | 13 |
高血压 | 678(41.1) | 2 | 2.91±0.89 | 8 |
脑血管病 | 342(20.7) | 3 | 3.00±0.95 | 4 |
慢性肺部疾病 | 322(19.5) | 4 | 2.67±0.96 | 10 |
肝脏疾病 | 269(16.3) | 5 | 3.05±0.98 | 3 |
血脂异常 | 256(15.5) | 6 | 2.89±1.00 | 9 |
糖尿病或血糖升高 | 221(13.4) | 7 | 3.13±0.94 | 2 |
胃部或消化系统疾病 | 138(8.4) | 8 | 3.00±0.95 | 4 |
情感及精神方面的问题 | 86(5.2) | 9 | 2.49±0.92 | 12 |
恶性肿瘤 | 75(4.5) | 10 | 1.92±0.85 | 14 |
肾脏疾病 | 71(4.3) | 11 | 3.00±1.00 | 4 |
与记忆相关的疾病 | 31(1.9) | 12 | 3.35±1.20 | 1 |
关节炎或风湿病 | 28(1.7) | 13 | 2.56±1.02 | 11 |
哮喘 | 17(1.0) | 14 | 3.00±1.14 | 4 |
排名 | 未共病(n=359) | 2种慢性病共病组合模式(n=581) | 3种慢性病共病组合模式(n=455) | |||
---|---|---|---|---|---|---|
疾病 | 例数 | 组合模式 | 例数 | 组合模式 | 例数 | |
1 | 心脏疾病 | 208(57.9) | 心脏疾病+高血压 | 132(22.7) | 高血压+心脏疾病+脑血管病 | 66(14.5) |
2 | 慢性肺部疾病 | 30(8.4) | 心脏疾病+慢性肺部疾病 | 76(13.1) | 高血压+心脏疾病+糖尿病或血糖升高 | 48(10.5) |
3 | 恶性肿瘤 | 28(7.8) | 心脏疾病+脑血管病 | 49(8.4) | 高血压+心脏疾病+慢性肺部疾病 | 36(7.9) |
4 | 高血压 | 20(5.8) | 高血压+血脂异常 | 43(7.4) | 高血压+心脏疾病+肝脏疾病 | 28(6.2) |
5 | 脑血管病 | 15(4.2) | 心脏疾病+肝脏疾病 | 25(4.3) | 高血压+心脏疾病+血脂异常 | 17(3.7) |
Table 3 Top five prevalent combinations of two and three chronic diseases in middle-aged inpatients
排名 | 未共病(n=359) | 2种慢性病共病组合模式(n=581) | 3种慢性病共病组合模式(n=455) | |||
---|---|---|---|---|---|---|
疾病 | 例数 | 组合模式 | 例数 | 组合模式 | 例数 | |
1 | 心脏疾病 | 208(57.9) | 心脏疾病+高血压 | 132(22.7) | 高血压+心脏疾病+脑血管病 | 66(14.5) |
2 | 慢性肺部疾病 | 30(8.4) | 心脏疾病+慢性肺部疾病 | 76(13.1) | 高血压+心脏疾病+糖尿病或血糖升高 | 48(10.5) |
3 | 恶性肿瘤 | 28(7.8) | 心脏疾病+脑血管病 | 49(8.4) | 高血压+心脏疾病+慢性肺部疾病 | 36(7.9) |
4 | 高血压 | 20(5.8) | 高血压+血脂异常 | 43(7.4) | 高血压+心脏疾病+肝脏疾病 | 28(6.2) |
5 | 脑血管病 | 15(4.2) | 心脏疾病+肝脏疾病 | 25(4.3) | 高血压+心脏疾病+血脂异常 | 17(3.7) |
自变量 | 患1种慢性病 | 患≥2种慢性病 | ||||||
---|---|---|---|---|---|---|---|---|
β | Wald χ2值 | P值 | OR(95%CI) | β | Wald χ2值 | P值 | OR(95%CI) | |
性别(以女为参考) | ||||||||
男 | 0.055 | 0.042 | 0.838 | 1.056(0.624~1.789) | 0.381 | 2.303 | 0.129 | 1.464(0.895~2.394) |
年龄(以55~59岁为参考) | ||||||||
45~49岁 | 0.271 | 0.488 | 0.485 | 1.312(0.613~2.806) | -0.027 | 0.005 | 0.942 | 0.974(0.474~2.000) |
50~54岁 | -0.522 | 2.968 | 0.085 | 0.593(0.328~1.075) | -0.774 | 7.563 | 0.006 | 0.461(0.266~0.801) |
民族(以藏族为参考) | ||||||||
汉族 | 3.288 | 8.985 | 0.003 | 26.778(3.120~229.793) | 1.330 | 7.221 | 0.007 | 3.783(1.433~9.983) |
回族 | 3.832 | 8.397 | 0.004 | 46.143(3.456~616.090) | 1.801 | 4.314 | 0.038 | 6.055(1.107~33.126) |
东乡族 | 3.970 | 6.497 | 0.011 | 52.966(2.502~1 121.195) | 2.246 | 3.701 | 0.054 | 9.449(0.959~93.133) |
职业(以其他作为参考) | ||||||||
在职 | -0.049 | 0.011 | 0.916 | 0.952(0.385~2.354) | 0.182 | 0.176 | 0.675 | 1.199(0.513~2.802) |
退休或无业 | -0.308 | 0.303 | 0.582 | 0.735(0.317~2.203) | -0.549 | 1.089 | 0.297 | 0.578(0.206~1.620) |
农民 | -0.503 | 2.338 | 0.126 | 0.605(0.317~1.152) | -0.777 | 6.417 | 0.011 | 0.460(0.252~0.839) |
入院途径(以其他机构转入为参考) | ||||||||
急诊 | 0.785 | 0.916 | 0.338 | 2.193(0.439~10.942) | 1.425 | 3.325 | 0.068 | 4.159(0.899~19.248) |
门诊 | -0.045 | 0.018 | 0.893 | 0.956(0.498~1.836) | 0.376 | 1.451 | 0.228 | 1.457(0.790~2.687) |
Table 4 Multivariate Logistic regression analysis of the influencing factors of chronic comorbidities in middle-aged inpatients
自变量 | 患1种慢性病 | 患≥2种慢性病 | ||||||
---|---|---|---|---|---|---|---|---|
β | Wald χ2值 | P值 | OR(95%CI) | β | Wald χ2值 | P值 | OR(95%CI) | |
性别(以女为参考) | ||||||||
男 | 0.055 | 0.042 | 0.838 | 1.056(0.624~1.789) | 0.381 | 2.303 | 0.129 | 1.464(0.895~2.394) |
年龄(以55~59岁为参考) | ||||||||
45~49岁 | 0.271 | 0.488 | 0.485 | 1.312(0.613~2.806) | -0.027 | 0.005 | 0.942 | 0.974(0.474~2.000) |
50~54岁 | -0.522 | 2.968 | 0.085 | 0.593(0.328~1.075) | -0.774 | 7.563 | 0.006 | 0.461(0.266~0.801) |
民族(以藏族为参考) | ||||||||
汉族 | 3.288 | 8.985 | 0.003 | 26.778(3.120~229.793) | 1.330 | 7.221 | 0.007 | 3.783(1.433~9.983) |
回族 | 3.832 | 8.397 | 0.004 | 46.143(3.456~616.090) | 1.801 | 4.314 | 0.038 | 6.055(1.107~33.126) |
东乡族 | 3.970 | 6.497 | 0.011 | 52.966(2.502~1 121.195) | 2.246 | 3.701 | 0.054 | 9.449(0.959~93.133) |
职业(以其他作为参考) | ||||||||
在职 | -0.049 | 0.011 | 0.916 | 0.952(0.385~2.354) | 0.182 | 0.176 | 0.675 | 1.199(0.513~2.802) |
退休或无业 | -0.308 | 0.303 | 0.582 | 0.735(0.317~2.203) | -0.549 | 1.089 | 0.297 | 0.578(0.206~1.620) |
农民 | -0.503 | 2.338 | 0.126 | 0.605(0.317~1.152) | -0.777 | 6.417 | 0.011 | 0.460(0.252~0.839) |
入院途径(以其他机构转入为参考) | ||||||||
急诊 | 0.785 | 0.916 | 0.338 | 2.193(0.439~10.942) | 1.425 | 3.325 | 0.068 | 4.159(0.899~19.248) |
门诊 | -0.045 | 0.018 | 0.893 | 0.956(0.498~1.836) | 0.376 | 1.451 | 0.228 | 1.457(0.790~2.687) |
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