本文選題：傷害 + 住院病人�。� 參考：《山東大學(xué)》2011年碩士論文

【摘要】：[研究背景] 傷害是一個嚴(yán)重威脅人群健康的世界性重要公共衛(wèi)生問題,其發(fā)生率高,因急救、康復(fù)及早死和殘疾而花費(fèi)巨額費(fèi)用,造成的經(jīng)濟(jì)損失和社會負(fù)擔(dān)遠(yuǎn)遠(yuǎn)超過任何一種傳染病或慢性非傳染疾病。全球疾病負(fù)擔(dān)的研究結(jié)果表明,發(fā)展中國家的疾病模式正在發(fā)生轉(zhuǎn)變,即由傳染病為主轉(zhuǎn)為以非傳染病和傷害為主。世界多數(shù)國家傷害都位于前四位或五位死因。隨著我國社會經(jīng)濟(jì)的發(fā)展,城市化和工業(yè)化進(jìn)程的加快,以及人口數(shù)量的增加,傷害的威脅將會呈持續(xù)上升的趨勢。據(jù)推算,我國每年至少有2億人次發(fā)生各種傷害,其中約6000多萬人需要急診就醫(yī)治療,1400萬人次需要住院治療,100多萬人發(fā)生殘疾。傷害也是我國1-34歲居民死亡的第一位死因。2005年衛(wèi)生部通知要求開展全國傷害監(jiān)測工作,同時印發(fā)《全國傷害監(jiān)測方案》,傷害正式納入國家疾病控制工作,但是此項監(jiān)測只是局限于醫(yī)院門診傷害監(jiān)測,不包含傷害住院監(jiān)測。目前國內(nèi)對傷害住院的研究也很多,但是未形成一個完整連續(xù)全面的監(jiān)測網(wǎng)絡(luò),黃島區(qū)的傷害住院病人的監(jiān)測2008年前也未開展。山東省自2008年開始在部分縣區(qū)實施傷害住院的試點(diǎn)工作,黃島區(qū)結(jié)合此次試點(diǎn),建立起覆蓋全區(qū)的傷害住院監(jiān)測網(wǎng)絡(luò)。本次研究的的數(shù)據(jù)就是來源于此次監(jiān)測,旨在了解黃島區(qū)的傷害住院的流行特征及醫(yī)療負(fù)擔(dān),為下一步的防治決策提供依據(jù)。 [研究目的] 1、分析2009年青島市黃島區(qū)傷害住院的流行特征及其住院費(fèi)用,從一定程度上了解傷害疾病負(fù)擔(dān)。 2、為制定有效的傷害干預(yù)措施及衛(wèi)生政策提供科學(xué)依據(jù),從而最終達(dá)到降低傷害發(fā)生、降低醫(yī)療負(fù)擔(dān)的目的。 [研究方法] 1、采用山東省疾病預(yù)防控制中心慢性病防治所提供的問卷,對因傷害住院病例進(jìn)行登記。通過對2009年傷害監(jiān)測資料進(jìn)行描述性研究分析,了解黃島區(qū)傷害住院的流行病學(xué)特征。 2、資料收集：收集全部青島市黃島區(qū)6家監(jiān)測醫(yī)院(二級以上公立醫(yī)療機(jī)構(gòu))2009年傷害住院病例資料,建立SPSS16.0數(shù)據(jù)庫進(jìn)行分析。 3、人口學(xué)資料來源于黃島區(qū)統(tǒng)計局公布的2009年人口數(shù)。 [結(jié)果] 在1844例符合要求傷害住院患者中,男女比例為3.98：1。傷害發(fā)生年齡主要集中在青壯年階段,其中20-44歲占總報告例數(shù)的46.42%。本市/縣戶籍的占57.01%,本地戶籍人口傷害發(fā)生率略高于流動人口。傷害發(fā)生的時間分布中,主要發(fā)生在3-10月(占89.05%),24小時分布高峰時間為上午7點(diǎn)至11點(diǎn)(占50.27%),次高峰時間為13點(diǎn)至20點(diǎn)(占38.34%)。傷害發(fā)生地點(diǎn)的年齡分布中除0-4歲年齡組多發(fā)生在家中外,其他年齡組人群傷害多發(fā)生在公路/街道、工業(yè)和建筑場所、家中,分別占46.58%、28.69%、13.29%。發(fā)生的主要原因是鈍器傷、機(jī)動車車禍、跌倒/跌落,分別占33.89%、28.58%、23.81%。其有償工作人員是傷害發(fā)生的高危人群(占49.24%)。傷害發(fā)生的原因有性別差異,男性以鈍器傷、機(jī)動車車禍、跌倒/墜落、刀/銳器傷為主,女性則以機(jī)動車車禍、跌倒/墜落、鈍器傷、刀/銳器傷、燒燙傷為主。不同年齡組的傷害發(fā)生原因分布中,5-14歲年齡組跌倒/依然是主要原因,但發(fā)生機(jī)動車車禍的比率明顯上升,15～64歲年齡組則以鈍器傷、跌倒/墜落、機(jī)動車車禍、刀/銳器傷為主,65歲以上人群跌倒/墜落、機(jī)動車車禍為主。傷害的發(fā)生意圖類型中,以非故意傷害為主(占81.56%),高文化水平、夏秋季節(jié)、晚上是發(fā)生故意傷害的相關(guān)因素。戶籍人群與流動人口在傷害發(fā)生的年齡構(gòu)成、文化程度構(gòu)成、職業(yè)構(gòu)成、傷害發(fā)生時的地點(diǎn)、活動分布上有明顯差異；戶籍人口較流動人口更容易受到交通事故、燒燙傷的傷害,流動人口更加容易受到鈍器傷害；流動人口傷害發(fā)生在工業(yè)建筑場的人口構(gòu)成遠(yuǎn)遠(yuǎn)高于戶籍人口,流動人口傷害發(fā)生在家中的比例相對于戶籍人口要低很多；戶籍人口在體育活動、休閑活動、家務(wù)/學(xué)習(xí)活動中傷害構(gòu)成高于流動人口。傷害發(fā)生的部位主要發(fā)生在頭面部(占48.10%),上肢(占21.15%),下肢(占18.71%)；傷害的性質(zhì)主要是是骨折(占33.73%)；不同原因?qū)е聜Φ慕Y(jié)局中治療后回家的1700例(占92.19%)；人均住院費(fèi)用5299.84元,日人均住院費(fèi)用353.79元,其中機(jī)動車車禍導(dǎo)致的人均住院費(fèi)用為8027.48元,日人均住院費(fèi)用406.31元。 [結(jié)論] 男性青壯年及文化程度偏低人群是傷害干預(yù)的重點(diǎn)人群,應(yīng)重點(diǎn)加強(qiáng)此類人群的安全意識教育及干預(yù)。傷害發(fā)生主要集中于上下班高峰期的交通傷害及進(jìn)行有償作業(yè)時的工業(yè)建筑場地,因此加強(qiáng)道路交通安全意識教育與工業(yè)建筑場地的安全防范是降低意外傷害的重要措施。在進(jìn)行不同類型傷害預(yù)防的時候應(yīng)根據(jù)性別、年齡、戶籍、時間、地點(diǎn)、職業(yè)的差異區(qū)別對待。與其他傷害類型導(dǎo)致的住院費(fèi)用比較,機(jī)動車車禍導(dǎo)致的直接經(jīng)濟(jì)負(fù)擔(dān)最沉重；傷害對黃島區(qū)造成的經(jīng)濟(jì)負(fù)擔(dān)嚴(yán)重,應(yīng)采取有效措施加以預(yù)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.

【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R181.3

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