三甲医院和社区医院老年慢性病共病现状调查

doi:10.3969/j.issn.1004-583X.2021.01.008

摘要/Abstract

摘要：

目的了解≥60岁老年人群慢性病共病现状及各慢性病间的相关性,为优化共病管理、制定共病防治措施提供参考依据。方法以天津市一个三甲医院和社区医院作为试点,回顾性连续纳入该院老年科住院及社区医院登记入册的≥60岁老年人群,收集并比较包括性别、年龄等一般人口学特征以及慢性病检出情况等。结果共纳入三甲医院老年科住院患者950例,社区医院老年人14 377例,两医院≥60岁老年人的慢性病检出率分别为94.3%和57.3%,两医院中高血压检出率分别为74.1%和51.9%,居于慢性病首位,慢性病相关性分析显示,高血压与糖尿病、脑卒中、冠心病等慢性病相关(P<0.05)。结论老年共病患者人数庞大,多数慢性病与高血压有关, 更应重视高血压的防治知识及治疗对策的普及和应用,还应加强三级医院与社区医院的联网互动建设,提高慢性病的防治水平。

关键词: 慢性病, 老年人, 共病现象, 医院, 社区

Abstract:

Objective To understand the status of comorbidity of chronic diseases in elderly people aged ≥60 years and their correlation, so as to provide reference for optimizing the management of comorbidities and formulating the prevention and control measures of comorbidities. Methods Taking a tertiary hospital and community hospital in Tianjin as a pilot, retrospective analysis was involved in the elderly ≥60 years who were hospitalized in the geriatric department of the tertiary hospital and the community hospital. The study collected and compared demographic characteristics including gender, age, and the detection of chronic diseases, etc.Results A total of 950 geriatric inpatients of a tertiary hospital and 14 377 elderly people in community hospitals were included in the study. The detection rates of chronic diseases in the elderly≥60 years in the two hospitals were 94.3% and 57.3%, respectively. The detection rates of hypertension in the two hospitals were 74.1% and 51.9%, respectively, ranking first in chronic diseases(P<0.05). Conclusion The number of elderly patients with comorbidities is huge,and most chronic diseases are related to hypertension. More attention should be paid to the popularization and application of hypertension prevention and treatment strategies, and the construction of networking and interaction between tertiary hospitals and community hospitals should be strengthened to improve the prevention and treatment level of chronic diseases.

Key words: chronic disease, aged, comorbidity, hospitals, community

中图分类号:

R592

张新卉, 谷雨萌, 王仲言, 王东来, 夏晓爽, 王林, 刘霞. 三甲医院和社区医院老年慢性病共病现状调查[J]. 临床荟萃, 2021, 36(1): 39-43.

Zhang Xinhui, Gu Yumeng, Wang Zhongyan, Wang Donglai, Xia Xiaoshuang, Wang Lin, Liu Xia. Status investigation of chronic comorbidity status in elderly at tertiary hospitals and community hospitals[J]. Clinical Focus, 2021, 36(1): 39-43.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.01.008

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I1/39

图/表 9

参考文献 20

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组别	例数	性别(例)		年龄[M(QR),岁]
组别	例数	男	女	年龄[M(QR),岁]
三甲医院	950	528	422	66[63, 72]
社区医院	14 377	6 562	7 815	76[68, 84]
统计值		χ²=35.392		U=-25.525
P值		<0.01		<0.01

组别	例数	性别(例)		年龄[M(QR),岁]
组别	例数	男	女	年龄[M(QR),岁]
三甲医院	950	528	422	66[63, 72]
社区医院	14 377	6 562	7 815	76[68, 84]
统计值		χ²=35.392		U=-25.525
P值		<0.01		<0.01

组别	例数	高血压	糖尿病	脑卒中	冠心病	抑郁症	COPD	高脂血症	恶性肿瘤
三甲医院	950	704(74.1)	327(34.4)	641(67.5)	469(49.4)	13(1.4)	21(2.2)	265(27.9)	4(0.4)
社区医院	14 377	7 461(51.9)	2 592(18.0)	751(5.2)	201(1.4)	103(0.7)	184(1.3)	2 541(17.7)	5(0)
χ²值		176.584	155.307	4 181.985	4 905.407	5.043	4.623	62.242	22.657
P值		<0.01	<0.01	<0.01	<0.01	0.025	0.032	<0.01	<0.01

组别	例数	高血压	糖尿病	脑卒中	冠心病	抑郁症	COPD	高脂血症	恶性肿瘤
三甲医院	950	704(74.1)	327(34.4)	641(67.5)	469(49.4)	13(1.4)	21(2.2)	265(27.9)	4(0.4)
社区医院	14 377	7 461(51.9)	2 592(18.0)	751(5.2)	201(1.4)	103(0.7)	184(1.3)	2 541(17.7)	5(0)
χ²值		176.584	155.307	4 181.985	4 905.407	5.043	4.623	62.242	22.657
P值		<0.01	<0.01	<0.01	<0.01	0.025	0.032	<0.01	<0.01

慢性病	年龄段				χ²值	P值
慢性病	60~69岁(n=287)	70~79岁(n=276)	80~89岁(n=317)	≥90岁(n=70)	χ²值	P值
高血压	226(78.7)	210(76.1)	228(71.9)	40(57.1)	15.067	<0.01
糖尿病	109(38.0)	95(34.4)	105(33.1)	18(25.7)	4.197	>0.05
脑卒中	194(67.6)	209(75.7)	207(65.3)	31(44.3)	26.396	<0.01
冠心病	100(34.8)	136(49.3)	195(61.5)	38(54.3)	43.611	<0.01
抑郁症	7(2.4)	4(1.4)	2(0.6)	-	4.699	>0.05
COPD	3(1.0)	5(1.8)	11(3.5)	2(2.9)	4.468	>0.05
高脂血症	118(41.1)	76(27.5)	66(20.8)	5(7.1)	47.832	<0.01
恶性肿瘤	1(0.3)	-	3(0.9)	-	3.586	>0.05