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中国循证儿科杂志

中国循证儿科杂志 ›› 2019, Vol. 14 ›› Issue (3): 161-168.DOI: 10.3969/j.issn.1673-5501.2019.03.001

• 论著 •    下一篇

上海市单中心儿科门诊特征和医疗服务2009至2018年趋势分析

张晓波1,10, 施鹏2,10, 郑珊3, 葛小玲2, 叶成杰4, 陆国平5, 沈国妹6, 吴小沪7, 曾玫8, 徐虹9   

  1. 复旦大学附属儿科医院 上海,201102,1 呼吸科;2 统计和数据管理中心;3 外科;4 信息网络管理中心;5 重症医学科;6 门急诊管理办公室;7 人力资源部;8 感染传染科;9 肾脏风湿科;10 共同第一作者
  • 收稿日期:2019-03-28 出版日期:2019-06-25
  • 通讯作者: 徐虹, E-mail:hxu@shmu.edu.cn

An analysis of characteristics and trends of outpatient visits and medical services in a tertiary pediatric hospital in Shanghai from 2009 to 2018

ZHANG Xiao-bo1,10, SHI Peng2,10, ZHENG Shan3, GE Xiao-ling2, YE Chen-jie4, LU Guo-ping5, SHEN Guo-mei6, WU Xiao-hu7, ZENG Mei8, XU Hong9   

  1. Children's Hospital of Fudan University, Shanghai 201102, China, 1) Department of Respiratory Disease, 2) Center of Statistics and Data Management, 3) Department of Surgery, 4) Center of Information and Internet Management, 5) Pediatric Intensive Care Unit, 6) Office of Outpatient and Emergency, 7) Human Resources Department, 8) Department of Infectious Disease, 9) Department of Nephrology and Rheumatology ; 10) Co-first author
  • Received:2019-03-28 Online:2019-06-25
  • Contact: XU Hong, E-mail: hxu@shmu.edu.cn

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摘要： 目的 探索医院信息系统(HIS)医疗大数据处理方法,分析儿童专科医院近10年门诊患儿就诊特征及医疗服务趋势。方法 以复旦大学附属儿科医院(我院)HIS门诊患儿就诊挂号登记表的全样本数据为基础,系统地进行数据清洗(诊断、地址、重复、离群、缺失)、数据集成(数据库链接和匹配)、数据规约、数据脱敏和数据核查,行门诊患儿就诊特征及医疗服务趋势的分析。结果 2009至2018年我院门诊挂号20 775 899人次,依据纳入和剔除标准,18 242 822 人次进入本文分析;男性占57.42%,婴儿占9.57%,幼儿占40.94%,学龄前儿童占24.82%,学龄儿童占24.67%。诊断缺失率为5.92%,地址缺失率为45.31%,接诊医生姓名缺失率为26.81%,行缺失数据人群分析,各年份性别和年龄构成比差别不大。10年间门诊量年平均增长5.22%,2012较2011年增长11.22%,2014较2013年增长10.93%,2015年后环比增长均<2.90%。10年间不同年份各省市门诊量>P75 和~P50的省市,从华东向西南、西北、华南、中部、东北扩大。10年间门诊医生平均日接诊51人次,初、中和高级职称医生门诊日均接诊分别63、54和45人次;专科门诊从2009年的46个发展为2018年的180个,2018年专科就诊比例达68.12%,专病门诊从2009年的16个发展为2018年的142个。结论 基于国家儿童医学中心之一的我院的门诊数据表明,10年间门诊量先快速增长后平稳增长,患儿来源地区快速从华东地区辐射至全国,门诊医生平均日接诊数量低于全国平均水平,专科门诊和专病门诊成为重要的发展趋势。

关键词: 儿科, 工作负荷, 门诊, 医院信息系统, 专病门诊, 专科门诊

Abstract: Objective To explore the processing Methods of big data of hospital information systems(HIS) and analyze the characteristics and trends of outpatient visits and medical services in a tertiary pediatric hospital in Shanghai during the past 10 years.Methods Data were extracted from the database of outpatient registry in HIS from 2009 to 2018. Data cleaning (diagnosis, address, replication, outliers, and missing data), data assembly (linkage of database), data reduction, data anonymization and data audit were conducted according to the procedure of big data. We analyzed the characteristics and trends of outpatient visits and medical services.Results The total outpatient visits from 2009 to 2018 were 20,775,899 and 18,242,822 visits were included in this study. Males were 4,656,843 accounting for 57.42%. Patients under 1 year old, from 1 to 3 years old, from 3 to 7 years old and from 7 to 18 years accounted for 9.57%,40.94%, 24.82% and 24.67% respectively. The missing data rate of diagnosis, address, and name of doctors was 5.92%, 45.31% and 28.61%,respectively. There were no significant differences in the percentage of sex and age in different years among the population with missing data. The average increasing rate of outpatient visits was 5.22% in the past 10 years. The increasing rate of 2012 and 2014 were 11.22% and 10.93% respectively, compared with the same period of last year. The increasing rate slowed down to 2.90% after 2015. The distribution of outpatient address showed the trends of expansion from the east of China to the South-west, North-west, South, Middle and North-east. The average workload of a doctor was 51 visits in a day. According to professional titles, there were 63, 54, and 45 visits per day for junior, intermediate, and senior doctors, respectively. The number of specialty clinics increased from 46 in 2009 to 180 in 2018 and serviced the 68.12% of outpatient visits. The number of specific disease clinics increased from 16 in 2009 to 142 in 2018.Conclusion The big data of outpatient visits in a tertiary pediatric hospital(National Children's Medical Center) in China showed that there was a sustainable upward trend in outpatient visits; the origin of patients expanded from Shanghai to the whole of China; the average visits for a single physician were lower than that of the country. Specialized clinics in specialties or diseases are an important trends for the development of children's hospitals.

Key words: Hospital information system, Outpatient, Pediatrics, Specialty clinic, Specific disease clinic, Workload