【摘要】：目的和意義對(duì)湖北省荊州市兩城區(qū)醫(yī)療機(jī)構(gòu)進(jìn)行回顧性調(diào)查,描述該地區(qū)2006年-2008年間流感相關(guān)疾病的住院負(fù)擔(dān),分析該類疾病的流行病學(xué)特征,為制定流感的防控策略提供科學(xué)依據(jù),同時(shí)也為即將在該地區(qū)開(kāi)展的基于人群的嚴(yán)重急性呼吸道感染病例監(jiān)測(cè)活動(dòng)提供基礎(chǔ)資料。 研究方法選定全市所有共36家醫(yī)療機(jī)構(gòu)為研究現(xiàn)場(chǎng),發(fā)放統(tǒng)一設(shè)計(jì)的調(diào)查問(wèn)卷,對(duì)全市醫(yī)療資源進(jìn)行調(diào)查;運(yùn)用文獻(xiàn)回顧法,綜合文獻(xiàn)中所述流感相關(guān)疾病定義并結(jié)合所調(diào)查地區(qū)的醫(yī)師對(duì)疾病命名的習(xí)慣,將所涉及疾病的ICD-10編碼細(xì)分到亞目,制定出本調(diào)查統(tǒng)一使用的流感相關(guān)疾病的病例定義。以此定義作為檢索關(guān)鍵變量,查閱各醫(yī)療機(jī)構(gòu)的住院病例,用統(tǒng)一的調(diào)查篩錄表收集相關(guān)信息。使用描述性分析的方法對(duì)該地區(qū)的流感相關(guān)疾病的住院負(fù)擔(dān)進(jìn)行評(píng)估,同時(shí)用SPSS17.0軟件對(duì)數(shù)據(jù)進(jìn)行卡方檢驗(yàn),分析比較不同年度、不同年齡組以及不同性別病例之間住院率的差異,并通過(guò)多分類非條件Logistic回歸分析對(duì)影響居民選擇不同級(jí)別醫(yī)療機(jī)構(gòu)治療流感相關(guān)疾病的因素進(jìn)行分析。 結(jié)果醫(yī)療資源調(diào)查發(fā)現(xiàn),全市醫(yī)療機(jī)構(gòu)共擁有床位6022張,年度住院總量為163300人次,其相應(yīng)構(gòu)成比均為綜合醫(yī)院最大,而社區(qū)衛(wèi)生服務(wù)中心最小。其構(gòu)成與擁有床位量相似。由病例回顧性調(diào)查得到,2006年1月1日~2008年12月31日間,共有27家醫(yī)療機(jī)構(gòu)收治了38020例流感相關(guān)住院病例,年平均住院率為11.0‰,呈逐年上升趨勢(shì)。0~1歲年齡組的住院率最高,達(dá)到335.0‰;65歲以上年齡組的病死率最高,達(dá)到1.8%。男性流感相關(guān)疾病住院率略高于女性。流感相關(guān)疾病在全年均可發(fā)生,其中3月份住院病例數(shù)最多,出現(xiàn)春季高峰。急性上呼吸道感染是導(dǎo)致當(dāng)?shù)鼐用褡≡鹤钪饕牧鞲邢嚓P(guān)疾病之一。通過(guò)多分類非條件Logistic回歸分析可知,影響患有流感相關(guān)疾病的居民選擇就診醫(yī)療機(jī)構(gòu)的因素可能包括年齡、性別以及入院年份等。 結(jié)論研究結(jié)果提示衛(wèi)生決策者應(yīng)該合理配置衛(wèi)生資源,尤其是加強(qiáng)基層醫(yī)療衛(wèi)生服務(wù)的建設(shè)。該地區(qū)流感相關(guān)疾病的住院負(fù)擔(dān)相對(duì)較重,特別是0-1歲兒童和65歲以上老年人群,為流感相關(guān)疾病的高危人群,是流感防治的重點(diǎn)對(duì)象。
[Abstract]:Objective and significance of retrospective investigation of medical institutions in two urban areas of Jingzhou City, Hubei Province, to describe the hospitalization burden of influenza related diseases from 2006 to 2008, and to analyze the epidemiological characteristics of these diseases. It provides a scientific basis for the formulation of influenza prevention and control strategies and provides basic information for the upcoming population-based surveillance of severe acute respiratory infection cases in the region. Methods A total of 36 medical institutions in the city were selected as the research site and a unified questionnaire was issued to investigate the medical resources of the whole city. Using literature review method, combining the definitions of influenza-related diseases mentioned in the literature and the doctors' habit of naming diseases in the investigated areas, the ICD-10 coding of the diseases involved was subdivided into suborders. Develop a unified case definition of influenza-related diseases used in this survey. This definition is used as a key variable to retrieve the inpatient cases in various medical institutions and to collect relevant information with a uniform survey and screening table. The inpatient burden of influenza related diseases in this area was assessed by descriptive analysis method, and the data were checked by chi-square with SPSS17.0 software, and analyzed and compared in different years. The differences of hospitalization rate among different age groups and different genders were analyzed. The factors influencing residents to choose different medical institutions to treat influenza-related diseases were analyzed by multi-classification non-conditional Logistic regression analysis. Results the investigation of medical resources showed that the total number of beds in medical institutions was 6022 and the total annual hospitalization was 163300 person-times. The corresponding constitution ratio was the largest in general hospitals and the smallest in community health service centers. Its composition is similar to the number of beds owned. From the retrospective investigation of cases, from January 1, 2006 to December 31, 2008, a total of 38020 influenza-related inpatients were admitted to 27 medical institutions, with an average annual hospitalization rate of 11.0 鈥，

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