Wang Zi Kai, Mo Jia Li, Zhang Meng, Liao Ji Ping
Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, 100034, China.
Departmant of Pediatrics, Peking University First Hospital, Beijing, 100034, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Dec 18;55(6):1074-1081. doi: 10.19723/j.issn.1671-167X.2023.06.019.
To study epidemiological characteristics and hospitalization costs of female inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing.
A retrospective study was conducted to analyze electronic hospitalization summary reports of female inpatients with AECOPD in Beijing from 2013 to 2020. Clinical characteristics (age distribution and comorbidities), epidemiological characteristics (temporal and spatial distribution characteristics), hospi-talization times and costs of patients were described.
A total of 57 911 subjects in 166 hospitals were included in this study, with a mean age of (78.84±8.59) years and the highest number of patients aged 80-89 years (49.06%), followed by patients aged 70-79 years (31.08%), and the lowest number of patients under 50 years (0.41%). The proportions of patients with coronary heart disease, hypertension and heart failure were 30.60%, 30.52% and 26.54% respectively. The median number of daily hospitalizations during the study period was 18 (: 16). The number of daily hospitalizations for AECOPD showed an overall growth trend over the eight years from 2013 to 2020, starting to increase significantly in 2015 and continuing to increase until 2019, then followed by a decline in 2020. The proportion of inpatient admissions was higher in winter and spring (54.09%) than that in summer and autumn (45.91%). The top three districts in terms of the proportion of total inpatient admissions were Xicheng district (14.18%), Chaoyang district (14.12%) and Fengtai district (13.47%). The density of inpatients was relatively high in the western regions, central urban areas and northeastern regions of the city, while the density of inpatients was relatively low in the near suburbs. The median number of hospital days for female patients with AECOPD was 12 days, and the median hospital costs was CNY 20 648.37. Patients from urban areas had longer hospitalization times and higher hospitalization costs than those from suburban areas ( < 0.001). Western medicine expenses accounted for the largest proportion of total hospital expenses (33.32%). During the study period, hospitalization costs exhibited an overall pattern of initial growth, followed by subsequent decline, eventually stabilizing. The differences in hospitalization costs among the patients with different comorbidities were significant.
Female hospitalized patients with AECOPD in Beijing were older than 70 years, often complicated by cardiovascular disease. AECOPD occurred mainly in winter and spring, with regional differences. The hospitalization costs were closely associated with the patients' age, comorbidities, and the geographicical region.
研究北京地区慢性阻塞性肺疾病急性加重期（AECOPD）女性住院患者的流行病学特征及住院费用。
采用回顾性研究方法，分析2013年至2020年北京地区AECOPD女性住院患者的电子住院病历汇总报告。描述患者的临床特征（年龄分布及合并症）、流行病学特征（时间和空间分布特征）、住院次数及费用。
本研究共纳入166家医院的57911例患者，平均年龄为（78.84±8.59）岁，80 - 89岁患者人数最多（49.06%），其次是70 - 79岁患者（31.08%），50岁以下患者人数最少（0.41%）。冠心病、高血压和心力衰竭患者的比例分别为30.60%、30.52%和26.54%。研究期间日均住院人数中位数为18（四分位间距：16）。2013年至2020年这八年间，AECOPD日均住院人数呈总体增长趋势，2015年开始显著增加，持续增加至2019年，随后在2020年有所下降。冬春季住院患者比例（54.09%）高于夏秋季（45.91%）。住院患者总数占比前三的区分别为西城区（14.18%）、朝阳区（14.12%）和丰台区（13.47%）。城区西部、市中心城区和东北部地区住院患者密度相对较高，近郊区住院患者密度相对较低。AECOPD女性患者住院天数中位数为12天，住院费用中位数为20648.37元。城区患者的住院时间和住院费用均高于郊区患者（<0.001）。西药费用占总住院费用的比例最大（33.32%）。研究期间，住院费用总体呈现先增长后下降，最终趋于稳定的态势。不同合并症患者的住院费用差异显著。
北京地区住院的AECOPD女性患者年龄在70岁以上，常合并心血管疾病。AECOPD主要发生在冬春季，存在地区差异。住院费用与患者年龄、合并症及地域密切相关。
