| Objective:GBD2019 data were used to estimate the disease burden of skin diseases in Chinese population to know the general situation of the skin disease burden in China;Taking Yichang City of Hubei Province as a typical area,described the epidemiology and cost characteristics of skin disease patients in medical institutions in Yichang City from 2017 to 2019,and the key skin diseases were analyzed to provide basic reference information for the prevention and control of skin diseases in Yichang City.Method:Based on the results of the GBD2019 study,the distribution and changes of the incidence,prevalence,mortality,DALY,YLL and YLD of skin diseases in Chinese population by age and sex were estimated from 1990 to 2019,to understand the disease burden of skin diseases in Chinese population.Based on the health data platform of Yichang City,a typical survey was conducted to describe and analyze the epidemiological characteristics(including population,time,departments,skin diseases)and direct medical expenses of outpatients and inpatients with skin diseases in all medical institutions from 2017 to 2019.Results:(1)Based on the results of the GBD2019 to estimate the skin diseases burdenGBD estimates that the incidence of skin diseases in the Chinese population in 2019 is 784 million,the number of patients is 369 million,and the number of deaths is 5,393.The standardized DALY rate was 592.08/100,000,the standardized YLL rate was 5.77/100,000,and the standardized YLD rate was 586.31/100,000.The people aged 15-49 years old has the highest DALYs and YLDs while the highest rates of DALY and YLD were found in people aged 5-14,and the highest YLLs and YLL rate were observed in the group over 70 years old.From 1990 to 2019,DALYs and YLDs of skin diseases increased slightly in China,while the rates of DALY and YLD didn't show a great change,women were higher than men.The people under 15 years old has the highest DALYs,DALY rate,YLDs and YLD rates of viral skin diseases,while the DALYs and DALY rates of dermatitis were the highest among people over 15 years old,and the DALYs,DALY rate,YLDs and YLD rates of infectious skin diseases in the lower age group were the highest,the rank of DALYs and DALY rates of fungal dermatosis and psoriasis in people over 50 years old increased obviously.(2)Epidemiological characteristics and direct medical expenses of outpatients and inpatients with skin diseases in Yichang city.From 2017 to 2019,the number of outpatient visits,the number of outpatients and the total medical expenses for the skin diseases showed an increasing trend in Yichang,with 2 visits per capita and an average cost of ? 115.85 per visit.There was a peak period from May to August,and February has the lowest outpatient visits.Different diseases had different peak periods.The number of visits for urticaria was the highest in summer and the lowest in winter,the acne has the lowest number of visits in spring and the highest in summer and autumn.The ratio of male to female patients was 0.73:1,and the medical expenses of female patients were 36.62%higher than that of male patients.Among the people under 15 years old and over 70 years old,male patients were more than female patients,while in other age groups,male patients were lower than female patients.Acne ranked the second in the 15-49 age group,and pruritus rose significantly in the group over 50 years old.The average cost per time was the lowest in the group under 5 years old and the highest in the people aged 15-49.From 2017 to 2019,the top 10 skin diseases in the number of outpatients in Yichang were:other dermatitis,urticaria,acne,Other local infections of skin and subcutaneous tissues,lichen simplex chronicus,contact atopic dermatitis,seborrhoeic,pruritus dermatitis,psoriasis and unspecified contact dermatitis.The medical expenses per visit of hypertrichosis,apocrine sweat disorders,other disorders of pigmentation,vitiligo and psoriasis ranked in the top 5.Compared to 2017,the number of visits for pruritus,other local infections of skin and subcutaneous tissues,psoriasis,acne,urticaria,and seborrheic dermatitis all increased by more than 20%in 2019.There are 4,325 inpatients of skin diseases in Yichang from 2017 to 2019,with an average age of 44.83 years old,the mean hospital day was 12.12 days,and an average cost was ?9151.85.The number and costs of male inpatients were higher than that of female patients.Summer has the highest number of inpatients with skin diseases and the lowest in winter.The number of inpatients reached a peak period from June to September.From the perspective of age distribution,15-49 years old has the largest number of inpatients,people aged 50-69 years old had the highest total cost,and 5-14 years old had the lowest total cost.The average cost per time increased with the increase of age.In Yichang,the top 10 skin diseases in the medical expenses of inpatients from 2017 to 2019 were other local infections of skin and subcutaneous tissues,other disorders of skin and subcutaneous tissue,decubital ulcer,other dermatitis,urticaria,ulcer of lower limb,skin abscesses?furuncle and carbuncles,cellulitis,atrophic disorders of skin and psoriasis.Both the total hospitalization costs and the average cost per time for lower extremity ulcers and decubitus ulcers were among the top ten,but the rank of hospitalization costs of lower extremity ulcers and decubitus ulcers decreased significantly,while the rank of medical expenses of cellulitis and psoriasis increased significantly,which should be paid more attention to.Conclusion:(1)Compared with 1990,skin disease burden increased steadily in 2019 in China.The disease burden of acne vulgaris showed a significant increase in the group aged 15-49,and people over 50 years old had an obviously increase for psoriasis.(2)From 2017 to 2019,the number of patients with skin diseases and the direct economic burden of skin disease in Yichang increased year by year.Acne,psoriasis and pruritus call for more attention in Yichang city. |
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