Analysis On The Characteristics,Disease Burden And ARIMA Model Of Injured Inpatients In Shenzhen From 2013 To 2018

ObjectiveBased on the first page data of the medical records of inpatients from 2013 to2018 as the research object,understand the time,region,and population distribution of injured inpatients in Shenzhen.Analyze the inpatients’disease burden and influencing factors of injured patients,and predict the injured inpatients.It provides basic information for the population to propose strategies for prevention and treatment of injury health,designation of health policies and medical and health plans,and also provides reference basis for rational allocation of medical resources and services and reduction of medical expenses.Methods1.Select the first page of inpatient medical records in Shenzhen from 2008 to2013 as the research object,select inpatient injury cases according to the code of ICD-10 and the inclusion standard of American trauma system,establish a database with Microsoft Excel,import sas9.4 software for statistical analysis,clean,check all data,fill or remove missing values,and change variables.2.Statistical description of time,region,population characteristics and disease spectrum,and comparative analysis of different characteristics of injury patients between groups byχ² test.3.Statistical description of hospitalization expenses of injury patients,comparison of hospitalization expenses of different characteristics by t-test or variance analysis,and analysis of influencing factors of injury hospitalization expenses by multiple linear regression model.4.ARIMA model was used to analyze the time trend of Injury Inpatients in 2013-2018,and to predict the injury inpatients,with a statistically significant difference of P<0.05.Results1.In 2013-2018,there were 6869220 inpatients in Shenzhen,435492 injured inpatients,including 306258 males（71.67%）,121063 females（28.33%）,37.13±18.99 years old,34.92±16.63 years old in males,42.72±23.01 years old in females,with the highest proportion（40.95%）in the 26-45 age group.The incidence of injury in>65 years old was higher in female than in male,and the sex ratio was 0.54.2.The Injury Inpatients accounted for 6.44%of the total inpatients.The average injury inpatient rate in Shenzhen was 64.7/10000,the average injury inpatient rate in men was 83.2/10000,and the average injury inpatient rate in women was 38.1/10000.Longgang District（657/10000）,Bao’an District（645/10000）and Pingshan district（643/10000）have the highest average hospitalization rate.The death of injured inpatients were 2470,1722 males（69.72%）and 748 females（30.28%）.The average death rate of injured hospitalized patients in Shenzhen is 3.5/10 million,the average death rate of male injury is 4.6/10 million,and the average death rate of female injury is 2.3/10 million.The top three types of injuries and deaths are head injuries（62.75%）,chest injuries（38.06%）,lower back and lumbar vertebrae and pelvic injuries（24.94%）.The damage composition of head injuries,chest injuries and other injuries in male patients is higher than that of females,and the composition of hip and thigh injuries of female death patients is higher than that of males.The fatality rate of injury was0.54%,the average fatality rate of injuries was 0.55%for men,and 0.60%for women.3.According to the inclusion criteria,the diseases that harm hospitalized patients are divided into 11 categories,of which wrist and hand injuries（24.60%）,head injuries（18.27%）,knee and calf injuries（13.74%）constitute the top three,and patients<15 years old Burns and corrosion injuries（27.82%）were higher,head injuries（15.98%）at 16-25 years old,wrist and hand injuries（51.56%）at 26-45 years old,and chest at 46-65 years old Injuries（36.40%）,hip and thigh injuries（38.03%）in the 65-year-old group,male patients with higher disease categories include wrist and hand injuries（81.98%）,and female hip and thigh injuries（43.84%）).Neck injuries are the highest in Futian District,hip and thigh injuries in Luohu District,chest injuries in Yantian District and Nanshan District,burns and corrosion injuries in Baoan District,and wrist and hand injuries in Longgang District,Longhua District and Guangming New District.Pingshan District suffered ankle and foot injuries,and Dapeng New District suffered head injuries.4.The number of injured patients admitted in February was the least,and the number was larger in June,July,and August.The critical illness among the inpatients admitted to the hospital was the highest.The highest rate of inpatient discharge was constituted by doctors’discharge,accounting for 94.71%.The ratio of non-medical orders to leave the hospital and the number of deaths were 4.18%and 0.45%,respectively.The average length of hospitalization for injured hospitalized patients was 13.4±23.05 days,with a median of 8 days.The highest proportion was in the8-14 day group.Accounted for 28.67%.The composition of Shenzhen household registration and non-Shenzhen household registration is 17.70%and 82.30%respectively.5.The total cost of injury hospitalization is 16369.30±34299.62 yuan,the general service fee is 2081.39±5453.26 yuan,the cost of Western medicine is2863.66±8509.02 yuan.The cost of injury is higher than that of general hospitalization.The total cost of injury hospitalization is 713 million yuan every year.The total cost of injury hospitalization is increasing year by year.The highest average cost of injury hospitalization is Luohu District（22316.90 yuan）.The highest average cost of hospitalization is hip and thigh injury（36809.80 yuan）.The multiple linear regressionmodel:Y=11.6910-0.5658X₁-0.3921X₂-0.2974X₃-0.2549X₄-0.1808X₅-3.5299X₆-2.7091X₇-2.1058X₈-1.5610X₉-0.9303X₁₀+0.1588X₁₁-0.0591X₁₂+1.0289X₁₃-0.8897X₁₄-0.8837X₁₅-0.4194X₁₆+0.2340X₁₇+0.1039X₁₈+0.2964X₁₉+0.3562X₂₀P<0.0001R²=0.5845C（p）=18.00.With the increase of age,the number of days in hospital increased,the cost of hospitalization increased,and the cost of hospitalization for dead patients,critical patients,surgical patients and patients with lower extremity injury was more than that of other patients.6.The highest hospitalization rate of wrist and hand injury patients was Longgang District（189/10000）.The hospitalization rate of male was 2.45/10000,and that of female was 0.62/10000.The hospitalization rate of male was much higher than that of female.The original time series fluctuated,and the number of patients with wrist and hand injuries in January or February of each year was less than that in other months.The 12 order difference of the original time series was used to get the optimal model ARIMA（1,0,0）₁₂.In 2018,the number of people predicting wrist and hand injuries was 18848,the prediction error was 2.10%,less than 5%,and the prediction effect was good.In 2019,the number of inpatients with wrist and hand injuries is predicted to be 19150.73.Conclusion1.Shenzhen’s injury hospitalization rate is at a relatively high level in Guangdong Province,and the occurrence of injuries in industrially developed areas such as Bao’an District and Longgang District is more prominent.Individualized prevention and control should be conducted for high-risk groups with different characteristics.2.Wrist and hand injuries are the first type of hospitalization for injury in Shenzhen.In particular,health education for male migrant workers on the occurrence of wrist and hand injuries should be strengthened.3.The cost of injured hospitalized patients in Shenzhen is higher than that of non-injured patients on average.Factors such as age,length of hospital stay,operation status,and location of injury have a greater impact on the cost of injury.4.The ARIMA model obtained in this study can better describe the distribution law of the number of wrist and hand injuries in Shenzhen,and the prediction effect is better.