摘要
目的探讨三级医院全科医学科中老年住院患者慢性非传染性疾病(NCD)共病现状及影响因素,以期为临床相关干预提供参考。方法本研究以2020年1月1日—2023年12月31日就诊于重庆医科大学附属永川医院且在全科医学科住院的2493例患者为研究对象,明确该群体NCDs共病的现状。采用多因素logistic回归分析NCDs患者共病的影响因素。结果在全科医学科的中老年住院患者中,男性1112例(44.6%),女性1381例(55.4%);患0、1、≥2种NCDs的患者分别有131例(5.26%)、389例(15.60%)和1973例(79.14%);患0、1、≥2种NCDs患者的性别、年龄、职业、医疗保险类型、住院时长比较,差异有统计学意义(P<0.05);患病率在30%以上的NCDs包括胃部或消化系统疾病(52.67%,1313/2493)、肺部疾病(43.20%,1077/2493)、高血压(42.20%,1057/2493)、脑血管病(39.83%,993/2493)、心脏疾病(31.13%,776/2493);2种NCDs共病的患者573例(22.98%),3种NCDs共病的患者589例(23.63%)。多因素logistic回归分析结果显示:年龄>59~64岁是中老年住院患者患1种NCD的影响因素(P<0.05);性别为女性,年龄≥60岁,入院方式为门诊,住院时长是中老年住院患者患≥2种NCDs的影响因素(P<0.05)。结论在三级医院全科医学科住院患者中,79.14%的患者处于NCDs共病状态;形成以胃部或消化系统疾病、高血压和脑血管病为核心疾病的3种最常见的NCDs共病组合模式;女性、年龄≥60岁是中老年患者NCDs共病的易发群体和高危群体。全科医学科应加强对患有多重NCDs特别是患有胃部或消化系统疾病、高血压和脑血管病共病模式的中老年尤其是女性群体的早期筛查,针对所在地区不同年龄段“多病共存”的特点,制定有针对性、个性化的中老年NCDs健康管理方案和干预措施。
Objective To explore the current status and influencing factors of chronic non-communicable disease(NCD)comorbidity among middle-aged and elderly inpatients in the Department of General Practice Medicine in tertiary hospitals,aiming to provide a reference for clinical interventions.Methods This study included 2493 patients admitted to the Department of General Practice Medicine at Yongchuan Hospital Affiliated to Chongqing Medical University from January 1,2020,to December 31,2023,to clarify the status of NCD comorbidity in this population.Multifactorial logistic regression analysis was used to examine the influencing factors of NCDs comorbidities.Results Among the middle-aged and elderly inpatients in the Department of General Practice Medicine,there were 1112 males(44.6%)and 1381 females(55.4%);patients with 0,1,and≥2 types of NCDs were 131(5.26%),389(15.60%),and 1973(79.14%)respectively.Comparisons of gender,age,occupation,type of medical insurance,and length of hospital stay among patients with 0,1,and≥2 types of NCDs showed statistically significant differences(P<0.05);the prevalence rates of NCDs above 30%were gastric or digestive system diseases(52.67%,1313/2493),pulmonary diseases(43.20%,1077/2493),hypertension(42.20%,1057/2493),cerebrovascular diseases(39.83%,993/2493),and heart diseases(31.13%,776/2493).The number of patients with comorbidity of 2 NCDs was 573(22.98%),and with comorbidity of 3 NCDs was 589(23.63%).Multifactorial logistic regression analysis showed that age>59-64 was an influencing factor for middle-aged and elderly inpatients with 1 type of NCD(P<0.05);being female,age≥60,admission through outpatient department,and hospital stay were influencing factors for middle-aged and elderly inpatients with≥2 chronic diseases(P<0.05).Conclusion In tertiary hospitals,79.14%of inpatients in the Department of General Practice Medicine are in a state of NCDs comorbidity;the three most common NCDs comorbidity patterns are centered around gastric or digestive system diseases,hypertension,and cerebrovascular diseases;females and those aged≥60 are the susceptible and high-risk groups for NCDs comorbidity among the middle-aged and elderly.The Department of General Practice Medicine should strengthen early screening for patients with multiple NCDs,especially for the elderly,particularly women,with comorbidity patterns of gastric or digestive system diseases,hypertension,and cerebrovascular diseases.Targeted and personalized health management plans and intervention measures for NCDs in middle-aged and elderly people should be developed following the characteristics of multimorbidity in different age groups in the region.
作者
李永军
李艳
冯桂波
秦月齐
黄秘
谢波
张瑜
Li Yongjun;Li Yan;Feng Guibo;Qin Yueqi;Huang Mi;Xie Bo;Zhang Yu(Information Center,Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160,China;Department of General Practice Medicine,Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160,China)
出处
《保健医学研究与实践》
2024年第7期20-26,共7页
Health Medicine Research and Practice
基金
重庆市卫生健康委员会科卫联合项目(2022MSXM177)。
关键词
慢性病共病
慢性病防治
全科医学
中老年住院患者
Chronic disease comorbidity
Chronic disease prevention and control
General practice
Middle-aged and elderly inpatients
