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中国循证儿科杂志

中国循证儿科杂志 ›› 2025, Vol. 20 ›› Issue (2): 95-101.DOI: 10.3969/j.issn.1673-5501.2025.02.003

• 论著 • 上一篇    下一篇

2019-2024年上海市市级医院儿内科重点病种收治现况和直接疾病经济负担的横断面调查

刘枭雄1,6，柳龚堡1,6，桂永浩1,5，侯冷晨2，余松轩2，叶颖子1，王淼3，王颖雯1，鲁冰3，冯瑞4，张崇凡1，王艺1，张晓波1,5   

  1. 1 国家儿童医学中心 复旦大学附属儿科医院 上海，201102；2 上海市申康医院发展中心 上海，200041；3 上海市儿童医院 上海，200062；4 复旦大学计算机科学技术学院 上海，200438；5 国家卫生健康委员会新生儿疾病重点实验室（复旦大学） 上海，201102；6 共同第一作者


  • 收稿日期:2025-01-09 修回日期:2025-02-11 出版日期:2025-04-25 发布日期:2025-04-25
  • 通讯作者: 王艺，张晓波

Cross-sectional survey on the status and direct economic burden of common pediatric diseases in municipal hospitals in Shanghai (2019 to 2024)

LIU Xiaoxiong1,6, LIU Gongbao1,6, GUI Yonghao1,5, HOU Lengchen2, YU Songxuan2, YE Yingzi1, WANG Miao3, WANG Yingwen1, LU Bing3, FENG Rui4, ZHANG Chongfan1, WANG Yi1, ZHANG Xiaobo1,5 #br#   

  1. 1 National Children's Medical Center/Children's Hospital of Fudan University，Shanghai 201102，China；2 Shanghai Hospital Development Center，Shanghai 200041，China；3 Shanghai Children's Hospital，Shanghai 200062， China；4 School of Computer Science, Fudan University, Shanghai 200438, China; 5 National Health Commission (NHC) Key Laboratory of Neonatal Diseases (Fudan University), Shanghai 201102, China; 6 Co-first author
  • Received:2025-01-09 Revised:2025-02-11 Online:2025-04-25 Published:2025-04-25
  • Contact: WANG Yi, email:yiwang@shmu.edu.cn; ZHANG Xiaobo, email: zhangxiaobo0307@163.com

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摘要： 背景：当前缺乏儿科常见重点疾病收治现况和直接疾病经济负担的描述性数据，影响相关干预措施和政策制定的针对性和有效性。 目的：了解上海市22家市级医院儿内科11个重点病种住院患儿的收治现状和直接疾病经济负担。 设计：横断面调查。 方法：通过上海市市级医院医疗质量评价与促进平台，回顾性收集2019年3月1日至2024年6月30日上海市22家儿内科联盟成员单位11个重点病种的住院患儿病案首页数据，采用描述性方法分析所监测重点病种的收治现状，包括体量性指标（收治例数）、技术规范性指标（输血率和抗菌药物使用率）、重返性指标（31 d内非计划重返住院率）、安全性指标（病死率和自动出院率）、效率性指标（平均住院日）以及直接疾病经济负担指标（均次药品费用、均次耗材费用、均次总费用和医疗服务费占比）。 主要结局指标：儿内科重点病种的收治现状指标。 结果：上海市市级医院儿内科的11个重点病种中，收治体量最大的是儿童社区获得性肺炎，其次是早产儿，且经年趋势均无显著变化；病死率和自动出院率均维持在低位，儿童社区获得性肺炎的直接疾病经济负担经年下降趋势显著。 结论：监测疾病中感染性疾病收治体量最大，整体治疗效果佳。应增加对儿童慢性病的监测力度，并进一步提高市级医院的信息化水平。

关键词: 市级医院, 儿科, 疾病收治, 经济负担

Abstract: Background：Existing research lacks comprehensive data on the treatment status and direct economic burden of common pediatric diseases, which hinders the development of targeted interventions and effective policies. Objective：To assess the current hospitalization trends and direct economic burden associated with 11 common pediatric diseases in the pediatric departments of 22 municipal hospitals in Shanghai. Design：Cross-sectional survey. Methods：A retrospective study was conducted using data from the Shanghai Municipal Hospital Medical Quality Evaluation and Promotion Platform. The study focused on medical record homepages data from 11 diseases of 22 hospitals within the alliance, covering the period from March 1, 2019, to June 30, 2024. Descriptive statistics were applied to evaluate hospitalization trends, including case volume, technical standards (transfusion and antibiotic usage rates), readmission rates (unplanned readmission within 31 days), safety indicators (mortality and voluntary discharge rates), efficiency measures (average length of stay), and the direct economic burden (average drug costs, consumable costs, total costs per case, and proportion of healthcare service costs). Main outcome measures：Status of common pediatric diseases. Results：Among the 11 diseases studied, pediatric community-acquired pneumonia had the highest case volume, followed by premature infants, with no significant year-over-year trend changes. Mortality and voluntary discharge rates remained low, and the economic burden for pediatric community-acquired pneumonia decreased significantly over the study period. Conclusion：Infectious diseases accounted for the majority of cases, with generally positive treatment outcomes. Increased focus on pediatric chronic diseases and further improvements in hospital informatization are recommended.

Key words: Municipal hospitals, Pediatric, Disease treatment and hospitalization, Economic burden