西北地区三甲医院2015～2017年疼痛科住院病人疾病谱特征数据分析
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摘要
目的:用大数据技术探讨西北地区7家三甲医院疼痛科住院病人的疾病谱分布特征,初步评价西北地区三级医院尤其是青海省疼痛科诊疗服务能力。方法:通过检索中卫云医疗大数据平台上的西北五省区三甲综合医院数据,筛选出其中7家规模相当的三甲医院疼痛科2015～2017年出院病人病案首页数据进行分析。结果:(1) 7家医院疼痛科住院病人总数8 485人次,占总住院病人的0.82%;青海省占比明显高于其他省区;(2)疼痛科病人入院途径以门诊为主;年龄集中分布于40～80岁,以女性居多。(3)疼痛科出院病人病种覆盖数量,青海省为90种,其他省区为78种;两地区疑难重症诊治覆盖率均为47.06%;收治病种以腰椎间盘突出居首位。(4)青海省平均住院日、平均住院费用高于其他省区,而药占比、耗材比、病死率均较低。(5) 3年间7家医院疼痛科共进行1403例与疼痛诊疗有关的手术操作,青海省手术操作量明显高于其他省区;关键医疗技术的基本标准覆盖率达到80%,推荐标准覆盖率为28.57%。结论:西北地区7家三甲医院疼痛科住院病人病种覆盖率、关键医疗技术基本标准覆盖率均较高,但疑难病种及关键医疗技术推荐标准覆盖率较低。青海省3家医院疼痛科的上述指标略好于其他省区的4家医院。本研究结果可为西北地区疼痛科内涵建设提供参考。
Objective: To explore the distribution characteristics of disease spectrum of hospitalized patients in the pain department of 7 Grade Ⅲ A hospitals in northwestern China by big data analysis and to preliminarily evaluate the capabilities of pain diagnosis and treatment at level 3 hospitals in Northwest region, especially in Qinghai province. Methods: By retrieving the data of Grade Ⅲ A general hospitals of five northwestern provinces in Zhong Wei Yun medical big data platform, the first page data of discharged patients medical records in the pain department of 7 Grade Ⅲ A hospitals of the same size from 2015 to 2017 were selected for analysis. Results:(1) The total number of hospitalized patients in the pain department of 7 hospitals was 8,485, accounting for 0.82% of the total number of hospitalized patients; Qinghai province had a significantly higher proportion than other provinces.(2) The way of admission was mainly outpatient service and the ages of hospitalized patients in pain department were between 40 and 80 years old. And most of them are female.(3) The numbers of disease coverage of patients discharged from the pain department was 90 in Qinghai province and 78 in other provinces; the coverage rates of severe and difficult diagnosis and treatment in both areas were 47.06%. Lumbar intervertebral disc herniation was the most disease to be admitted.(4) The average hospitalization days and average hospitalization expenses in Qinghai province were higher than those in other provinces, while the drug proportion, material consumption ratio and mortality rate were lower.(5) A total of 1,403 cases of operations related to pain diagnosis and treatment were performed in the pain department of 7 hospitals in 3 years and the amount of operation in Qinghai province was significantly higher than that in other provinces; the basic standards coverage rate of key medical technologies reached 80% and the recommended standard coverage rate was 28.57%. Conclusion: In the pain department of 7 Grade Ⅲ A hospitals in northwestern China, the disease coverage rate of inpatients and the basic standards coverage rate of key medical technologies were relatively high, but the coverage rates of difficult diseases and key medical technology recommendation standards were lower. The above indexes of pain department of 3 hospitals in Qinghai province were slightly better than those of 4 hospitals in other provinces. Results of this study provide a reference basis for the connotation construction of pain departments in northwest China.
Objective: To explore the distribution characteristics of disease spectrum of hospitalized patients in the pain department of 7 Grade Ⅲ A hospitals in northwestern China by big data analysis and to preliminarily evaluate the capabilities of pain diagnosis and treatment at level 3 hospitals in Northwest region, especially in Qinghai province. Methods: By retrieving the data of Grade Ⅲ A general hospitals of five northwestern provinces in Zhong Wei Yun medical big data platform, the first page data of discharged patients medical records in the pain department of 7 Grade Ⅲ A hospitals of the same size from 2015 to 2017 were selected for analysis. Results:(1) The total number of hospitalized patients in the pain department of 7 hospitals was 8,485, accounting for 0.82% of the total number of hospitalized patients; Qinghai province had a significantly higher proportion than other provinces.(2) The way of admission was mainly outpatient service and the ages of hospitalized patients in pain department were between 40 and 80 years old. And most of them are female.(3) The numbers of disease coverage of patients discharged from the pain department was 90 in Qinghai province and 78 in other provinces; the coverage rates of severe and difficult diagnosis and treatment in both areas were 47.06%. Lumbar intervertebral disc herniation was the most disease to be admitted.(4) The average hospitalization days and average hospitalization expenses in Qinghai province were higher than those in other provinces, while the drug proportion, material consumption ratio and mortality rate were lower.(5) A total of 1,403 cases of operations related to pain diagnosis and treatment were performed in the pain department of 7 hospitals in 3 years and the amount of operation in Qinghai province was significantly higher than that in other provinces; the basic standards coverage rate of key medical technologies reached 80% and the recommended standard coverage rate was 28.57%. Conclusion: In the pain department of 7 Grade Ⅲ A hospitals in northwestern China, the disease coverage rate of inpatients and the basic standards coverage rate of key medical technologies were relatively high, but the coverage rates of difficult diseases and key medical technology recommendation standards were lower. The above indexes of pain department of 3 hospitals in Qinghai province were slightly better than those of 4 hospitals in other provinces. Results of this study provide a reference basis for the connotation construction of pain departments in northwest China.
引文
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[9]徐梅玲,张育珠.颈椎间盘突出症病人应用低温等离子消融术治疗的临床效果.山西医药杂志,2016,45(24):2927~2930.
[10]张育珠,徐梅玲.低温等离子以纤维环为靶点射频消融治疗盘源性腰痛手术的分析.中国医药科学,2018,8(3):26~28.
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[13]黄更飚.老年人慢性疼痛的研究进展探究.中国疼痛医学杂志,2018,24(2):196~198.
[14]张德仁,蒋劲,张敏,等.疼痛科的建设与管理.中国疼痛医学杂志,2001,7(2):109~111.
[15]王蕊,于洋,陈付强.脊髓电刺激治疗带状疱疹后神经痛疗效的临床研究.中国疼痛医学杂志,2017,23(8):616~618.
[16]舒伟,胡永生,陶蔚,等.脊髓电刺激治疗带状疱疹后神经痛的临床研究.中国临床神经科学,2018,26(1):57~61.
[17]罗裕辉,熊东林,蒋劲,等.短时程脊髓电刺激治疗带状疱疹性神经痛的疗效观察.中国疼痛医学杂志,2016,22(2):118~122.
[2]国家卫生与计划生育委员会.住院病案首页数据填写质量规范(暂行)[EB/OL].20160627143337674.pdf http://www.nhfpc.gov.cn/ewebeditor/uploadfile/2016/06/20160627143337674.pdf
[3]国家卫生与计划生育委员会.住院病案首页数据质量管理与控制指标(2016年版)[EB/OL].20160627143 357766.pdf http://www.nhfpc.gov.cn/ewebeditor/uploadfile/2016/06/20160627143357766.pdf
[4]国家卫生部.三级综合医院评审标准实施细则(2011年版)[EB/OL].02b5187a195c42e0855e4e27445fc2f0.pdf http://www.nhfpc.gov.cn/zwgk/wtwj/201304/0404f-9cd71764ab29b2365e069cfbf2d/files/02b5187a-195c42e0855e4e27445fc2f0.pdf
[5]国家卫生部.三级综合医院医疗质量管理与控制指标(2011年版)[EB/OL].http://www.nhfpc.gov.cn/zwgkzt/wsbysj/201101/50495.shtml
[6]国家卫生与计划生育委员会.三级综合医院医疗服务能力指南(2016年版)[EB/OL].www.nhfpc.gov.cn/ewebeditor/uploadfile/2016/10/20161020101032482.pdf http://www.nhfpc.gov.cn/ewebeditor/uploadfile/2016/10/20161020101032482.pdf
[7]王芳,倪家骧.脊髓电刺激治疗神经病理性疼痛疗效评定.中国实用神经疾病杂志,2017,20(9):36~39.
[8]段宝霖.疼痛科管理和发展的思考.全国疼痛科建设高峰论坛论文集,2015.
[9]徐梅玲,张育珠.颈椎间盘突出症病人应用低温等离子消融术治疗的临床效果.山西医药杂志,2016,45(24):2927~2930.
[10]张育珠,徐梅玲.低温等离子以纤维环为靶点射频消融治疗盘源性腰痛手术的分析.中国医药科学,2018,8(3):26~28.
[11]胡晓蓉.星状神经节阻滞术治疗颈椎病临床观察.青海医药杂志,2005,35(10):28.
[12]蔡宏澜,段宝霖,王雅,等.慢性疼痛病人伴发焦虑、抑郁和躯体化症状的现况分析.中国疼痛医学杂志,2017,23(10):788~790.
[13]黄更飚.老年人慢性疼痛的研究进展探究.中国疼痛医学杂志,2018,24(2):196~198.
[14]张德仁,蒋劲,张敏,等.疼痛科的建设与管理.中国疼痛医学杂志,2001,7(2):109~111.
[15]王蕊,于洋,陈付强.脊髓电刺激治疗带状疱疹后神经痛疗效的临床研究.中国疼痛医学杂志,2017,23(8):616~618.
[16]舒伟,胡永生,陶蔚,等.脊髓电刺激治疗带状疱疹后神经痛的临床研究.中国临床神经科学,2018,26(1):57~61.
[17]罗裕辉,熊东林,蒋劲,等.短时程脊髓电刺激治疗带状疱疹性神经痛的疗效观察.中国疼痛医学杂志,2016,22(2):118~122.