Johnson M, Duncan L, Rothenberger A, Thomas J
University of Arkansas, Little Rock, USA.
J Ark Med Soc. 2001 Mar;97(9):315-8.
The purpose of this study was to examine age and Major Diagnostic Categories (MDCs) and compare the variables to mortality and length of stay among inpatient women age 50 and over. Archival statistical data were obtained for 2,238 inpatients in a private, nonprofit hospital in 1998. The ages ranged from 50 to 107 years old, with a mean age of 71.21 years. Quantitative analyses were conducted to examine the data from a private, nonprofit hospital and determine if there were significant relationships between age, major diagnostic category, length of stay, and mortality in older women. The MDC distribution indicated that the highest frequency of diseases and disorders were in the following three systems: circulatory system, musculoskeletal system and connective tissue, and the digestive system. The average length of stay was 8.01 days. The 30-day readmission percentage and the 365-day readmission percentage were 12.24% and 28.02%, respectively. The mortality rate was 6%. In addition, 63.97% went home after discharge, and 67.07% were Medicare recipients. The risk of musculoskeletal diseases and disorders increased with age (p = .0001). The conditional probability of death was nearly nine times higher for the diseases of the nervous system, myeloproliferative diseases and disorders, poorly differentiated neoplasms and respiratory diseases. As age increased, the probabilities of a long hospital stay decreased. The mortality analyses found that the lowest probabilities of survival were in categories of myeloproliferative diseases and disorders, poorly differentiated neoplasms, and infectious and parasitic diseases. According to current health statistics, our society is getting older. Not only are people living longer, they are accessing more health care (American Association for World Health, 1999). Overall, the average life expectancy at birth has been identified at 76.5 years. The female has a longer life expectancy than the male, averaging 5.8 years longer. The highest life expectancy has been identified in the white female, who can expect to live to 79. The black woman has the second-highest life expectancy, 74.7 years. Peters, Kochanek, and Murphy reported an all-time-low age-adjusted death rate for the United States and a continuing trend in the decline in mortality for all age groups. With a growing number of people living longer, there is a need to know about the most common health issues that affect quality of life. The top three national causes of death in older Americans were diseases of the heart, malignant neoplasms, and cerebrovascular diseases/stroke. Arkansas health statistics mirror the national statistics. In April 1999, the Arkansas Department of Health reported that 30.5% percent of all female deaths were caused by heart disease. Malignant neoplasms were responsible for 20.1%, followed by cerebrovascular diseases at 10.8%. Other than three Connecticut hospital studies that explored the relationship of diagnosis code, mortality, and readmission, research is meager in this area. There is a need for hospital-based research that addresses the diagnosis categories and the relationship to age and other variables.
本研究的目的是调查年龄和主要诊断类别（MDCs），并将这些变量与50岁及以上住院女性的死亡率和住院时间进行比较。获取了1998年一家私立非营利性医院2238名住院患者的档案统计数据。年龄范围为50至107岁，平均年龄为71.21岁。进行了定量分析，以检查来自一家私立非营利性医院的数据，并确定老年女性的年龄、主要诊断类别、住院时间和死亡率之间是否存在显著关系。MDC分布表明，疾病和病症的最高频率出现在以下三个系统中：循环系统、肌肉骨骼系统和结缔组织以及消化系统。平均住院时间为8.01天。30天再入院率和365天再入院率分别为12.24%和28.02%。死亡率为6%。此外，63.97%的患者出院后回家，67.07%的患者是医疗保险受益人。肌肉骨骼疾病和病症的风险随年龄增加而增加（p = .0001）。神经系统疾病、骨髓增殖性疾病和病症、低分化肿瘤和呼吸系统疾病的死亡条件概率几乎高出九倍。随着年龄的增加，住院时间长的概率降低。死亡率分析发现，骨髓增殖性疾病和病症、低分化肿瘤以及传染病和寄生虫病类别的生存概率最低。根据当前的健康统计数据，我们的社会正在老龄化。人们不仅寿命更长，而且获得的医疗保健也更多（美国世界卫生协会，1999年）。总体而言，出生时的平均预期寿命已确定为76.5岁。女性的预期寿命比男性长，平均长5.8岁。白人女性的预期寿命最高，预计可活到79岁。黑人女性的预期寿命次之，为74.7岁。彼得斯、科查内克和墨菲报告称，美国的年龄调整死亡率创历史新低，所有年龄组的死亡率持续呈下降趋势。随着越来越多的人寿命延长,有必要了解影响生活质量的最常见健康问题。美国老年人的三大全国性死因是心脏病、恶性肿瘤和脑血管疾病/中风。阿肯色州的健康统计数据反映了全国的统计数据。1999年4月，阿肯色州卫生部报告称，所有女性死亡中有30.5%是由心脏病引起的。恶性肿瘤占20.1%，其次是脑血管疾病，占10.8%。除了三项探索诊断代码、死亡率和再入院之间关系的康涅狄格州医院研究外，该领域的研究很少。需要开展基于医院的研究，以解决诊断类别以及与年龄和其他变量的关系。
