The Study On Diabetes Medical Data Processing And Drug Utilization

Diabetes has become a major disease that will be affect on people’s health.Thediabetes prevalence of men, women, and the total population in China is12.0%,9.5%and10.5%, respectively[1]. In order to improve the treatment of diabetes and reduce expenses,it should do the in-depth research for the diabetes treatment, drug utilization andexpenditures. Hospital medical data is an information collection of medical technology,hospital management, cost changes, drug use,etc.It is a valuable resource for retrospectivestudies in medical management. However, the existing medical data is very difficult indigging, because of the lack of uniform standards code and the unstandardized inputinformation.This study will do the mining analysis on the hospital diabetes medical data.Objective: First, to explore the route of diabetes medical data processing techniquesand establish a retrospective analysis of medical data; Second, to provide an evaluation indrug utilization, to assess the utilization of drugs in hospitalized patients with diabetes, toprovide references for diabetes medications, drugs choices and the rational drugmanagement in hospital.Methods: First, we writed a program to extract the sample data statement, andextracted the basic information hospitalized patients with diabetes, treatment prescription,biochemical indicators, charge details and other medical data in hospital HIS system from2003to2013by using the SQL statements; second, adopted the automatic check andartificial check combination method to clean the data basing on ICD-10, ATC, NewPharmacology (17th edition), we did the standardized cleaning process of the diseaseclassification and drug name, then re-import it into the Oracle database, and did thestatistical analysis by using PL/SQL statements; Third, applied multi index to evaluatedrug utilization, we calculated the average length of hospitalized patients with diabetes,charge details, drug DDDs, DUI, DDC, using strength and per capita costs and otherfactors by disease, age and year.Results: First, the prevalence of diabetes increased and people with this diseasestarted earlier.All hospitalized patients with diabetes increased18.50%on average annually,8.15%higher than the Endocrinology which is10.35%,the number and rate of50-60year-old age group of hospitalized patients increased year by year in endocrinology and thewhole hospital, the number and proportion dropped significantly in over70years agegroup; Second, the drugs for diadete are effective and trategies of treatment are appropriate, it was decreased gradually diabetes associated with endocrinology neurologicalcomplications, diabetes associated with renal complications, diabetes associated withocular complications, diabetes associated with peripheral circulatory complications anddiabetes associated with ketoacidosis of the hospital and in the hospital and endocrinology;Third, The average hospitalization days should not be used as the index to evaluate theresult of treatment of diabetes mellitus, result of analyse showed changes of patientshospitalized diabetic fasting plasma glucose were not related with hospitalization days,hospital management factors affecting hospitalization is more significant,the inpatientaverage length of the hospital and Endocrinology has been reduced from22.08,15.80daysin2003to9.41,8.64days in2013, respectively, the average annual decline was8.04%,5.70%, respectively, In2009and2011, the hospital performance evaluation policyadjustment significantly reduced the average hospitalization days；Fourth, the total costincreased and the drugs cost declined.the total cost of hospitalized patient per day isannually increasing from857.34RMB,410.68RMB in2003to2951.01RMB,1069.08RMBin2013with an average annually increasing of13.44%and10.30%, respectively;. thedrugs cost in the hospital and endocrinology gradually rose from27.96%,25.96%in2003to43.66%,36.05%in2009, respectively, then annually declined to38.42%,29.01%in2013; Fifth, the DUI increased.the DUI in the hospital and endocrine hospitalized inpatientincreased from0.73and0.70in2003to0.98and1.53in2009, and then fell back to0.80and1.14in2013,the DUI of the blood pressure lowering drugs was greater than that indiabetes associated with ocular complications, diabetes associated with ketoacidosis anddiabetes associated with peripheral circulatory complications, the DUI and DDC the bloodpressure lowering drugs in hospitalized patients of hospital inpatients were significantlyhigher than those of Endocrinology, and the hospital antihypertensive drug DUI wasgreater than1; Sixth, the first-line drugs for diabetes were screened preliminary.Thecombined use of insulin and short acting insulin became more often, in oral hypoglycemicdrugs metformin、glimepiride and acarbose usage took the first place in biguanide、sulfacarbaminde and α-glucosidase inhibitors;Seventh, the drugs for blood pressure andlipid lowering were screened，which were used with the drugs for diabetes.the nifedipine,irbesartan and amlodipine usage ranked the top three in11years, angiotensin convertingenzyme inhibitors, such as benazepril, enalapril and perindopril gradually reducing,nifedipine, amlodipine, valsartan and enalapril were in the2012edition of "nationalEssential Drugs List",lipid-lowering drugs were mainly hydroxymethyl glutaryl coenzyme a (HMG-CoA) reductase inhibitors, the usage of simvastatin was the most in11years,atorvastatin and rosuvastatin catched up.Conclusions: Analysis of large clinical data, data extraction and cleaning rules mustestablish standardly.In this study, we did processing analysis of diabetes medical data byusing Oracle database, SQL and PL/SQL, comprehensivly. Our study showed that Thisstudy can provide reference methodology for medical data processing of other diseases andretrospective analysis, and will provide the basis for a prospective study of drug use. Largesample of drug utilization evaluation results show that The hospital diabetes drug treatmentis consistent with the diagnosis and treatment of the recommended scheme in domestic andinternational guidelines, But college and hospital endocrine specialist on drug treatment ofdiabetic patients significantly,but treatment strategies in Endocrine specialist and thant ofother departments are differences, should be strengthened the management ofintervention.