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成都市帕金森病和帕金森综合征住院患者共病情况及其共病负担和经济负担比较

周笑楠 廖诗艺 赵琴 王洋洋 周晓媛 邱培媛 万洋

周笑楠, 廖诗艺, 赵琴, 王洋洋, 周晓媛, 邱培媛, 万洋. 成都市帕金森病和帕金森综合征住院患者共病情况及其共病负担和经济负担比较[J]. 中国公共卫生, 2023, 39(11): 1407-1411. doi: 10.11847/zgggws1141941
引用本文: 周笑楠, 廖诗艺, 赵琴, 王洋洋, 周晓媛, 邱培媛, 万洋. 成都市帕金森病和帕金森综合征住院患者共病情况及其共病负担和经济负担比较[J]. 中国公共卫生, 2023, 39(11): 1407-1411. doi: 10.11847/zgggws1141941
ZHOU Xiaonan, LIAO Shiyi, ZHAO Qin, WANG Yangyang, ZHOU Xiaoyuan, QIU Peiyuan, WAN Yang. Comorbidity pattern/burden and economic burden of chronic diseases among inpatients with Parkinson′s disease and Parkinsonism in Chengdu city: a comparative analysis on hospitalization records of 2013 – 2017[J]. Chinese Journal of Public Health, 2023, 39(11): 1407-1411. doi: 10.11847/zgggws1141941
Citation: ZHOU Xiaonan, LIAO Shiyi, ZHAO Qin, WANG Yangyang, ZHOU Xiaoyuan, QIU Peiyuan, WAN Yang. Comorbidity pattern/burden and economic burden of chronic diseases among inpatients with Parkinson′s disease and Parkinsonism in Chengdu city: a comparative analysis on hospitalization records of 2013 – 2017[J]. Chinese Journal of Public Health, 2023, 39(11): 1407-1411. doi: 10.11847/zgggws1141941

成都市帕金森病和帕金森综合征住院患者共病情况及其共病负担和经济负担比较

doi: 10.11847/zgggws1141941
基金项目: 科技部国家重点研发计划项目(2020YFC2006503);四川省科技厅(2022NSFSC0668)
详细信息
    作者简介:

    周笑楠(1999 – ),硕士在读,研究方向:流行病与卫生统计

    通信作者:

    万洋,E-mail:wanyang2014@scu.edu.cn

Comorbidity pattern/burden and economic burden of chronic diseases among inpatients with Parkinson′s disease and Parkinsonism in Chengdu city: a comparative analysis on hospitalization records of 2013 – 2017

More Information
  • 摘要:   目的  了解四川省成都市帕金森病和帕金森综合征住院患者的共病情况及其共病负担和经济负担,为帕金森病和帕金森综合征患者的治疗与管理提供科学依据。  方法  收集成都市医保局2013年1月 — 2017年12月30436条帕金森病和3740条帕金森综合征住院患者的医保记录数据,通过《疾病和有关健康问题的国际统计分类》第十次修订本(ICD-10)编码识别疾病并用Charlson共病指数(CCI)评价共病负担,比较帕金森病和帕金森综合征住院患者的共病情况以及共病负担和经济负担,并应用多元线性逐步回归模型分析CCI得分对其经济负担的影响。  结果  成都市30436例次帕金森病和3740例次帕金森综合征住院患者中,分别有72.23%和73.26%的住院患者有共病,2种疾病住院患者共病比例差异无统计学意义(P > 0.05);帕金森病和帕金森综合征住院患者共病比例居于前3位的疾病均为脑血管病、慢性肺部疾病、糖尿病(伴有终末器官损害),共病比例分别为49.21%和51.23%、19.25%和20.64%、15.54%和16.34%;帕金森病和帕金森综合征住院患者最主要的二元共病组合均为脑血管病 + 慢性肺部疾病,共病比例分别为9.45%和11.34%,最主要的三元共病组合均为脑血管病 + 慢性肺部疾病 + 糖尿病(伴有终末器官损害),共病比例分别为1.30%和2.03%;21983例次帕金森病和2740例次帕金森综合征共病住院患者中,患1、2、3、4、 ≥ 5种共病比例分别为51.95%和47.34%、34.67%和35.51%、11.44%和14.01%、1.74%和2.99%、0.20%和0.15%,2种疾病共病住院患者的共病种数差异有统计学意义(χ2 = 45.21,P < 0.001);帕金森病和帕金森综合征住院患者的CCI平均得分分别为(1.39 ± 1.28)分和(1.49 ± 1.36)分,次均住院医疗费用分别为(11031.75 ± 110.88)元和(12885.81 ± 288.57)元,2种疾病住院患者共病负担和经济负担差异均有统计学意义(均P < 0.001);在控制了性别、年龄、医院等级和住院天数等混杂因素后,多元线性逐步回归模型分析结果显示,帕金森病和帕金森综合征住院患者的次均住院医疗费用差异无统计学意义(β = 0.017,95%CI = – 0.003~0.071),但会随患者CCI得分的升高而增加(β = 0.066,95%CI = 0.061~0.071)。  结论  成都市帕金森病与帕金森综合征住院患者的共病比例较高且共病负担和经济负担均较重,脑血管病、慢性肺部疾病和糖尿病(伴有终末器官损害)是帕金森病与帕金森综合征患者最主要的共病。
  • 表  1  成都市帕金森病和帕金森综合征住院患者各慢性病共病情况比较

    Table  1.   Differences in comorbidity ratios of chronic diseases between inpatients with Parkinson′s disease (30 346 person-times) and Parkinsonism (3 740 person-times) in Chengdu, 2013 – 2017

    慢性病种类帕金森病(n = 30436)帕金森综合征(n = 3740)χ2P
    共病例数共病比例(%)共病例数共病比例(%)
    脑血管病1497949.21191651.235.410.020
    慢性肺部疾病586019.2577220.644.100.043
    糖尿病(伴有终末器官损害)472915.5461116.341.610.204
    外周血管疾病23887.853178.481.810.178
    充血性心力衰竭22647.442807.490.010.916
    轻度肝脏疾病17495.752055.480.430.510
    痴呆13444.422957.8987.93 < 0.001
    糖尿病(无终末器官损害)8622.831273.403.760.052
    中度或重度肾脏疾病5271.73561.508.020.005
    任何肿瘤(包括白血病、淋巴瘤,除了皮肤恶性肿瘤)4991.64711.901.360.243
    胃十二指肠溃疡2480.81210.562.740.098
    结缔组织病2260.74230.610.750.387
    心肌梗死810.27110.290.100.755
    中度或严重肝脏疾病760.25190.511.090.297
    偏瘫700.23110.290.580.447
    伴有转移的实质性肿瘤590.1970.190.010.930
    艾滋病20.0110.030.294 a
      注:a 采用Fisher确切概率法检验。
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  • 接收日期:  2023-04-03
  • 录用日期:  2023-10-09
  • 修回日期:  2023-07-28
  • 网络出版日期:  2023-11-28
  • 刊出日期:  2023-11-01

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