| Objectives:Based on the information of inpatients in a tertiary general hospital in Taizhou City,this paper aims to describe the trend of the number of admissions and the distribution characteristics of gender and age from 2014 to 2019,and discuss the reasons for the change of the number of admissions,describe the disease composition and change trend of inpatients,to provide a reference for rational allocation of health resources and scientific formulation of disease prevention and control strategies,analyze the influence factors of hospitalization expenses and discuss the reduction of hospitalization expenses.Methods:The data of inpatients in a tertiary general hospital of Taizhou from2014 to 2019 were collected,including gender,age,marital status,admission route,admission date,discharge date,whether there were operations,number of operations,main diagnosis,ICD-10 code,number of secondary diagnoses,length of stay,outcome and total cost.Using descriptive research method to analyze the characteristic information and disease composition of inpatients.Using trend chi-square test to analyze the changing trend of inpatients’disease,single factor,and multi factor analysis to analyze the influence factors of hospitalization expenses.Results:In the past six years,332184 inpatients were admitted to the hospital,of which49424 were in 2014;in 2019,the number of inpatients was 60839,with an average annual growth rate of 4.24%;there were relatively more inpatients in summer,accounting for 26.6%of the total inpatients in the whole year;the male and female inpatients were 155485 and 176699,respectively,with a male to female ratio of0.880:1,but the growth rate of male inpatients was faster(χ2 trend=27.25,P trend<0.001);the average age of inpatients was（46.77±25.10）years old,and the proportion of inpatients aged 60 years and above was the most,and the constituent ratio showed an increasing trend(χ2 trend=875.91,P trend<0.001).The top 10 systemic diseases in our hospital were respiratory system diseases,pregnancy,and delivery and puerperium,circulatory system diseases,urogenital system diseases,digestive system diseases,tumors,injury poisoning and some other consequences of external causes,eye and appendage diseases,factors affecting health status and contact with health institutions,musculoskeletal system,and connective tissue diseases,and the top 10 systemic diseases accounted for 83.7%in total,the top10 single diseases accounted for 25.8%,cerebral infarction was the most common single disease,accounting for 3.6%of hospitalized patients;the majority of patients hospitalized for respiratory system in the past six years,and its constituent ratio showed a downward trend with the change of years(χ2 trend=161.46,P trend<0.001),but in recent years（since 2017）,the constituent ratio has increased(χ2 trend=85.75,P trend<0.001),winter and spring seasons.The proportion of hospitalized patients with respiratory diseases was higher than that in summer and autumn（χ2=379.12,P<0.001）,pneumonia was the most common single disease of respiratory diseases;patients in pregnancy,childbirth,and puerperium ranked the second,and the constituent ratio continued to decrease with years(χ2 trend=731.33,P<0.001),but the constituent ratio of urogenital diseases showed an upward trend(χ2 trend=285.65,P<0.001).Some infectious diseases and parasitic diseases only ranked the 10th in2014,and then did not appear in the top 10,accounting for 35.0%of the total number of inpatients in the system in summer.The leading causes of systemic diseases in different age groups were different.Respiratory diseases（60.0%）,respiratory diseases（42.8%）,pregnancy,delivery and puerperium（45.5%）,urogenital diseases（12.7%）,and circulatory diseases（19.6%）were the leading causes of hospitalization in the age groups<5 years old,5-14 years old,15-44 years old,45-59 years old and 60 years old and above.The number of hospitalized patients with chronic non-communicable diseases was 201309,with an average annual growth rate of 6.42%,the ratio of male to female was 1.082:1,and the number of male inpatients was slightly more than that of the female.The average length of stay was 8.08 days,and the proportion of inpatients with hospitalization days≤5 days showed an increasing trend（P<0.001）,and the annual average length of stay decreased from 9.28 days in 2014 to 6.81 days in 2019.The total hospitalization expenses increased from 499 million yuan in 2014 to589 million yuan in 2019,with an increased rate of 18.03%;the hospitalization expenses of circulatory system diseases were the highest,accounting for 17.35%;the univariate t/F test showed that gender,age,length of stay,operation,secondary diagnosis,admission route,outcome,and season were the influence factors of hospitalization expenses;multiple linear regression showed that gender,age,length of stay,operation or not,secondary diagnosis,admission route,outcome,and season were the influencing factors of hospitalization expenses Age,length of stay,number of surgeries,number of a secondary diagnosis,route of admission,outcome and season affect the cost of hospitalization.Conclusions:The number of inpatients in our hospital is increasing year by year,and there are more patients in summer,so it is suggested to pay attention to common diseases and frequently-occurring diseases in summer;female patients are the majority,and the growth rate of male inpatients is higher than that of the female;the proportion of elderly inpatients are the highest,and its constituent ratio shows an increasing trend.The respiratory diseases in the hospital are the first place,which is prevalent in children and the elderly.Most of them are in winter and spring.Pneumonia is the most common single disease of the respiratory system.Therefore,we should pay more attention to the health of children and the elderly,especially in winter and spring.At the same time,we should strengthen the prevention and control of pneumonia.Infectious diseases and parasitic diseases are more common in summer,although the incidence rate has declined in recent years,we should be vigilant.The number of inpatients with chronic non-communicable diseases increased year by year,among which cerebral infarction patients were more common.The average length of stay decreased year by year.The total hospitalization expenses are increasing,among which the hospitalization expenses of circulatory system diseases account for the highest proportion;the longer the hospitalization time,the higher the expenses.Therefore,strengthening the medical quality management,optimizing the hospitalization process,reasonably controlling the waiting time of examination and operation,and shortening the hospitalization days are effective methods to reduce the hospitalization expenses. |
