Objective To investigate the situation of MRI examination in children in outpatient and inpatient departments of the Sichuan Provincial People’s Hospital from 2010 to 2012, so as to provide favourable basis for the choice of imaging examination in children. Methods The materials of electronic reports of MRI examination in paediatric inpatient and outpatient departments from 2010 to 2012 were collected, categorized, and analyzed. Results a) 2 148 children underwent MRI examination in the Sichuan Provincial People’s Hospital from 2010 to 2012. The total number of patients increased with year. Boys were more than girls. The positive incidence was slightly decreased. The number of outpatients was more than inpatients, but the positive incidence was lower in outpatients. b) The total numbers of examination position were increased with year and the number of single position examination was the most (accounted for than 85% of the total numbers). The main examination positions included: head, MRA of the head, cervical column, knees, lumbar column, pituitary gland, thoracic column, and abdomen. The examination positions diversified gradually. The application of examination technique also increased gradually. c) The systemic disease spectrum of positive cases in MRI examination included 9 categories, which accounted for 42.86% of ICD-10. The nervous systematic disease, muscle, skeleton and connective tissue disease were the categories. The major disease types were stable during the recent 3 years. The increase was obvious in injuries of the knees, malacosis and atrophy of the brain, the deformity of the brain. Conclusion The total numbers of the patients and positions examined increased gradually with year in the Sichuan Provincial People’s Hospital from 2010 to 2012. The applications of MRI in the head, limbs and joints, and soft tissues were more extensive. Children diagnosed as positive results had diseases of the central nervous system, limbs and joints, and connective tissue disease.
ObjectiveTo understand the inpatient classification and influence factors of hospitalization expenses, so as to provide basis for hospital management.
MethodsThe diagnosis and treatment data of inpatients in a grade A tertiary hospital in 2013 were collected, the percentile method were used to describe the expenses distribution, the K-means clustering method was applied to classify the inpatients, the rank-sum test was utilized to analyze the differences of the costs among different groups, ICD-10 was applied to analyze the diseases distribution, and the median regression was used to analyze the influence factors.
ResultsThere were 175 333 inpatients in total. The median of the expenses was 10 016.31 yuan RMB. The inpatients might be classified into seven groups with different expenses (P=0.0001). For inpatients who had no "blood transfusion cost", the top three factors of cost category were operation, laboratory test, examination; for who had "blood transfusion cost", the top three factors of cost category were blood transfusion, laboratory test, examination. There were 2 147, 2 182, 1 499, 1 301, 2 059, 22 and 14 kinds of diseases (ICD-10 four-digit code) respectively among the seven groups. The influence factors could be summarized into patient-related and diagnosis & treatment-related ones.
ConclusionThe costs of operation, blood transfusion, laboratory test, and examination affect the inpatients classification greatly. The results could be of help to inform the admission of patients, the expense control and the disease management.
ObjectiveTo investigate the burden of disease in Xinjin county of Chengdu city from 2009 to 2010. so as to provide baseline data for the study on the healthcare service system.
MethodsThe prevalence of diseases among outpatients and inpatients in Xinjin county was collected and then analyzed using Microsoft Excel 2003 and SPSS 13.0 software.
Resultsa) The numbers of out-patient and in-patients with the top 20 diseases had been increased by 106.8% and 43.2%, respectively in 2010 than those in 2009. According to International Statistical Classification of Diseases (ICD)-10, the diagnosis of the diseases involved in 11 types of diseases among outpatients. For out-patients, the top 3 categories were diseases of respiratory, digestive systems and injury, poisoning and certain other consequences of external causes, accounting for 85.06% and 82.69% of total diseases in 2009 and 2010, respectively. Among them, upper respiratory infections, acute bronchitis and superficial injury cumulatively accounted for 61.61% in 2009 and 59.53% in 2010. b) The diagnosis of the diseases involved in 12 types of diseases among in-patients. For in-patients, the top 4 categories were diseases of the respiratory system, pregnancy, disease during childbirth and puerperium, digestive and the circulatory systems. Among them, the diseases of the respiratory system accounted for 53.55% and 50.82% in 2009 and 2010, respectively. The top 4 diseases among in-patients were acute bronchitis, chronic bronchitis, COPD, and acute gastritis, accounting for 48.12% and 49.54% cumulatively in 2009 and 2010. Meanwhile, the prevalence of hypertension and diabetes increased dramatically into the top 10 diseases. c) The acute diseases were mainly distributed in township hospitals, while the chronic diseases were mainly distributed in county-level hospitals.
ConclusionThe major burden of diseases is the diseases of the respiratory, digestive and circulatory diseases in Xinjin county of Chengdu city from 2009 to 2010. The chronic diseases are mainly distributed in county-level hospitals, while the acute diseases are mainly distributed in township hospitals or community healthcare centres. The common diseases are relatively stable which provide better conditions for the selection and use of the essential medical services and essential medicine list.
【摘要】 目的 分析地市級急救中心院前急救中損傷患者臨床特點，科學地指導院前急救診斷處置及急診外科資源配置。 方法 回顧性分析2009年1-12月份自貢市急救中心出診的全部有效病例中損傷患者出診資料，分析其疾病譜、季節、月份、時刻分布特點。 結果 全年院前急救損傷患者共1 922例，排名前5位的分別為:頭部損傷，涉及身體多個部位的損傷，膝和小腿損傷，腹部、背、腰椎和骨盆損傷，髖和大腿損傷，所有分類構成比男性均多于女性；損傷季節分布以冬季較多（Plt;0.05）；分布以1、11、12月份為多；時刻分布以凌晨0:00~6:00為出診最少時段。 結論 國際疾病分類（ICD-10）為規范院前急救疾病譜提供參考，根據損傷類疾病譜可確定急診外科工作及發展重心，依據季節、月份及時刻分布特點能指導急救資源合理配置。【Abstract】 Objective To provide scientific guidance of assistances for patients sustaining injuries and of effective resource allocation of emergency surgery by analyzing the pre-hospital features of injuries in urgent rescue centers at the local or city level. Methods All cases of injuries in pre-hospital emergency care during the year of 2009 were studied. The spectrum of diseases, and the seasons, the months, and the time points of the diseases were analyzed. Results There were totally 1 922 patients of pre-hospital emergency care in the whole year. Based on the International Classification of Diseases 10th Revision (ICD-10), top five classifications were injuries to the head, injuries involving multiple body regions, injuries to the knee and lower leg, injuries to the abdomen, lower back, lumbar spine and pelvis, and injuries to the hip and thigh. For all kinds of injuries, the number of male patients was more than that of the female. The cases in winter were more than those in other seasons (Plt;0.05). The cases in January, November and December were more than those in other months. The cases between 0:00 am and 6:00 am were less than those at other time points. Conclusion ICD-10 could provide reference for standardizing the spectrum of diseases in pre-hospital care. The focus of emergency surgery may be guided by the spectrum of injuries. The features of the season, the month, and time point of diseases can offer practical help for resource allocation in pre-hospital care.
