| Objective:This study aims to understand distribution of three and disease spectrum,and to analyze burden of diseases caused by respiratory tract infection of hospitalized children in Shanxi Province from 2013 to 2016.Moreover,the study aims to provide a scientific basis for childhood diseases prevention,treatment,and for reasonable allocation of medical resources.Methods:According to the Shanxi Province unified hospital report data interface standards,collected statistical information in the database including 109 hospitals in the province from July 1,2013 to June 30,2016,and chose the 0～14 years old children as analysis object.According to the global burden of disease(GBD)standard and international classification of diseases(ICD-10)on the main discharge diagnosis completed the classification of diseases.Using SQL Server and Excel imported and analyzed the data,compare different ages,different sex,different areas and different time of children,analyzed disease spectrum composition and the sequence change of children patients in different ages,gender,regional,and time.Using chi-square test in SPSS 20.0 analyzed the difference of gender distribution between different age groups.After identifying key diseases,analyzed the burden of epidemiology,direct and indirect economic burden for all hospitalized children and key diseases in the hospital,and use the time prediction model to predict average hospitalization expenses in 2017.Results:The study object into a total of 60 7516 people,including the boy 364747 person-time,and the sex ratio was 1.5:1.The group of 1～4 years old was the most,followed by<1 year old group.After one year of age,children hospitalized times reduced gradually with the increase of age.Boys were more than girls in all ages,and the sex ratio was highest in 10～14 years old,up to 1.69:1,then 1～4 years old,5～9 years old,<1 year old group.Checked by χ2 test,gender distribution difference of hospitalized children between different ages was statistically significant(χ2= 0.029,P<0.029).In 11 cities,hospitalized children in Taiyuan were most,up to 160185 people,accounting for 26.37%of the total number of hospitalized children.Hospitalized children accounted for 28.49%of the total number of people in spring,summer(20.70%),autumn(18.92%),winter(31.89%),and hospitalized children in winter were significantly higher than fall.December to June in next year was the peak period of hospitalization children,most children hospitalized people in January,followed by March,February,and month total people accounted for 33.23%of total passengers.Sorting all system disease,respiratory infections lined first,people in hospitalized children with respiratory tract infection number accounted for 48.90%of the total number of people.All the 11 kinds of system disease attendances of hospitalized boys were higher than girls hospitalized patients,sex ratio of the urogenital system diseases was the highest(male/female = 4.52).In addition to<1 year old group of the sequence of the disease first was the produced in the perinatal period,was 58.40%,and the other age groups were respiratory tract infection.Respiratory infection accounted for the most in each season,but in the winter of respiratory tract infection accounted the highest(60.90%),proportion of infectious and parasitic diseases(15.80%)and urogenital system diseases(2.76%)was the highest in the summer.Among all the hospitalized children,the cure rate was 72.03%,the recovery rate was 23.10%,and the non-cure rate was 2.22%,the mortality rate was 0.07%.The average hospitalization days were six days,the average hospitalization cost was RMB 4311.45,the average western medicine fee was RMB 1434.80,and the average antibacterial drug cost is RMB 328.63.Cure rate of boys(72.64%)than girls(71.12%).Cure rate of<1 year old group(58.64%)was lowest,and mortality rate(0.20%)was highest,the highest cure rate occurred in 1～4 years old,at 77.10%.Most average hospitalization expense was in<1 year old group,up to RMB 6504.21,the least was 1～4 years old at RMB 3252.84.Average hospitalization days of non-cure children were least for 3 days.Death children has the highest average hospitalization expenses,up to RMB 14572.37.Average hospitalization days of diseases of the digestive system,were least for 5 days,and diseases produced in the perinatal period were most,up to 7 days.Average hospitalization cost of diseases produced in the perinatal period was the highest,up to RMB 7984.60,and respiratory infections was the lowest at RMB 2356.54.The "optimal" equation Children of hospitalized costs influence factors analysis was:y =2314.864+459.888x1-2844.593x2+3035.114x3+1560.881x4+120.085x5 regression model had statistical significance.Among 286143 hospitalized children for respiratory infections,the cure rate was 81.11%,the recovery rate was 17.16%,and the non-cure rate was 1.19%,and mortality was 0.02%.5～9 years old group had the highest cure rate,up to 82.49%,however,cure rate of 10～14 years old group was lowest,at 76.19%.The outcome of 5～9 years old group was the best.By analyzing the influence factors of hospital outcome,hospital admission outcome of general situation was significantly better than that of critical patients,OR was 1.837.The greater the age and length of stay,the worse the prognosis of discharge.Potential life lost years of hospitalized children for respiratory tract infections were 3888.97 years,and the life loss caused by untimely death of hospitalized children with respiratory tract infection were 1846.08 years.People distribution of hospitalization days more concentrated within 7 days,accounting for 75.59%.The main influence factors of children hospitalization days for respiratory tract infection were the hospital prognosis and the status of entrance.Indirect economic burden of hospitalized children with respiratory tract infections was RMB 9.6894 million,and the hospital total cost were RMB 470 million,the average hospitalization was RMB 2356.54 with the skewness distribution.The optimal model of time prediction model was ARIMA(2,1,0),forecasts indicated monthly average hospitalization cost trend of hospitalized children for respiratory tract infections in 2017 is relatively stable,focused on RMB 2190,forecast was statistically significant.Conclusions:From 2013 to 2016,children hospitalized in Shanxi show a trend of increasing year by year,and children hospitalized of boys,1～4 years old group and Taiyuan city were high-risk groups of children.Winter and spring are high-risk seasons for children in the hospital,so should be focus on prevention.Respiratory tract infection disease remains high,disease produced in the perinatal period in<1 year old group of children is most often generated.The genitourinary system disease of boys should also be regarded as the key.Prevention of infectious and parasitic diseases should be pay attention to in summer.Children hospitalized for pandemic influenza and pneumonia among children with respiratory tract infection in the hospital still has high mortality rate.Direct and indirect economic costs of hospitalized children with respiratory infection are high,individuals,families and society all have large pressure.According to the result of the first three years,the trend of average hospitalized expense for hospitalized children with respiratory tract infections in 2017 is relatively stable and gradually reduce,which indicated that Shanxi Province medical institution reform of the medical expenses can be produced results. |
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