| Bronchopneumonia is one of the most common diseases of lower respiratory tract infection,especially in infants and children with a higher incidence,more commonly seen in infants under 3 years old,can occur throughout the year.Due to the weak immune system of children,when the inflammatory response develops rapidly,it can accumulate other tissues and organs all over the body.In severe cases,children may suffer from respiratory,circulatory,nervous and other systemic complications,which seriously affect the quality of life of children and even threaten their life safety.In recent years,the incidence of children's bronchopneumonia is on the rise,which is one of the 30 single diseases in the national health and family planning statistical yearbook.The disease not only affects the healthy growth of children,but also brings economic pressure and extra burden to their families and society.This study analyzed the epidemic characteristics and admission time sequence of children's bronchopneumonia in Shengjing hospital affiliated to China medical university in the past 20 years,providing reference for the prevention and control of children's bronchopneumonia in northern China.Through the literature metrological analysis of the cost of children's pneumonia,the international research hotspots and future trends in this field are understood,and the relevant research in the future can be used for reference.At the same time,this paper analyzed the costs of hospitalized children with bronchopneumonia from 2013 to 2017,grasped the basic rules,identified the main influencing factors,and provided scientific basis for taking targeted measures to reasonably control costs.The whole subject is divided into three parts.Part ? The epidemic characteristics of pediatric inpatients with bronchopneumoniaObjective:The incidence of bronchopneumonia in children is increasing,which is one of the single diseases.The disease not only affects the healthy growth of children,but also brings economic pressure and extra burden to their families and society.Understanding the epidemic characteristics of children's bronchopneumonia can provide reference for disease prevention and control.Methods:(1)Demographic and clinical data of hospitalized children with bronchopneumonia were analyzed.(2)time series analysis was used to establish the ARIMA product seasonal model to analyze the monthly admissions of children with bronchopneumonia.Results:(1)from January 1997 to December 2017,a total of 33,025 cases of children's bronchopneumonitis were admitted to Shengjing hospital affiliated to China medical university,and the number of patients showed an increasing trend year by year.The ratio of male to female in hospitalized children with bronchopneumonia was 1.49 to 1.The proportion of children under 1 year old is 32.5%,with the highest number.The proportion of school-age children(> 6 years old)is the least,11%.The mode of medical payment was dominated by insurance(87.3%),and the trend was increasing year by year.Most of the hospitalized patients were critical patients,accounting for 88.1%.33.6% of children with bronchopneumonia had rescue experience during hospitalization.80.7% of children with bronchopneumonia showed improvement after treatment.The number of patients hospitalized for more than 7 days accounted for 62.6%.(2)the number of children admitted to hospital with bronchopneumonia showed a fluctuating and rising trend,from 415 in 1997 to 4801 in 2017,and showed a cyclical change with the change of month.The number of children admitted to Shengjing hospital of China medical university was lower in June,July,August,September,October and November,among which October was the month with the lowest number of children admitted to hospital.Admissions were higher in other months,with January the highest month for children with bronchopneumonia.Conclusion:(1)children under 1 years of age with bronchopneumonia is the key point of prevention.(2)in the summer,autumn is the season of low incidence of children bronchopneumonia,winter,spring is a season,especially in January,parents,schools and other places of prevention and control should be strengthened,the missionary work,reduce the incidence of bronchial pneumonia in children,at the same time to strengthen the hospital medical staff training work,do a good job in response.Part ? Bibliometric Analysis and Visual Presentation of The Cost of Childhood PneumoniaObjective:Articles on the costs of childhood pneumonia are important information resources for understanding trends in the field and predicting future trends.In order to understand the research on the cost of children's pneumonia,bibliometrics method was adopted to analyze the current research hotspots in this field,so as to provide reference for future work.Methods:In this study,we used co-word clustering analysis and strategic coordinates and other visualization methods to detect the research hotspots related to the cost of children's pneumonia,counted the frequency of "subject word+subsubject word" field,and established the subject word matrix in this field.The matrix was imported into SPSS19.0 for system clustering and tree graph was drawn.According to the tree graph,the semantic relations of high frequency theme words/subtheme words are classified to obtain the subjects studied in this category,and then the international research hotspots on the cost of children's pneumonia are obtained.Results:(1)The research on the cost of children's pneumonia showed a growing trend.Since 1991,the number of publications related to the cost of children's pneumonia increased rapidly.(2)Pneumonia/epidemiology,hospitalization/statistics and numerical data,pneumococcal vaccine/economics were the top three subjects+sub-subjects in the literature.The research on the cost of children's pneumonia focuses on vaccine prevention and control,bacterial infection,drug treatment,epidemiology and treatment and prevention.(3)The study found that after clustering vaccine for prevention and control,epidemiology,treatment and prevention of this three kinds of research subject + subheadings within close-knit and is closely related with external various again at the same time,to illustrate the research tendency of three kinds of mature,is the international children's pneumonia disease cost research field is the core problem.Conclusion:At present,the research on the cost of children's pneumonia in China still needs to be strengthened.According to the results of co-word cluster analysis,it is known that the current research hotspot of children's pneumonia in the world is vaccine prevention and control,epidemiology,treatment and prevention,and we can pay attention to these three research directions in the future.Part ? Analyzes The Correlative Factors of The Disease Cost of Children's Bronchopneumonia InpatientsObjective: Through the analysis of the cost of children's bronchopneumonia disease and the study of the influencing factors,we can analyze the factors of unreasonable increase,discuss the method of reducing the cost of hospitalization,and provide reference for the rational allocation of medical resources and cost-benefit analysis.Methods:Univariate and multivariate methods,Decision tree analysis were used to analyze the characteristics of hospitalized children with bronchopneumonia.Results:From 2013 to 2017,the inpatient costs of pediatric bronchopneumonitis in Shengjing hospital affiliated to China medical university decreased year by year,which was mainly related to the decrease of drug costs.Nursing cost,treatment operation cost and medical service fee account for a relatively low proportion in the cost structure.The inpatient cost of infantile children with bronchopneumonia is higher;The illness when be admitted to hospital is more critical,there is rescue during be in hospital,the patient that be in hospital days is more than 7 days spends on be in hospital charge taller.The order that affects cost of be in hospital to spend from big to small is: have without rescue,have without complication,be admitted to hospital circumstance,turn circumstance,be in hospital days,age and medical treatment pay a way.Conclusion: The hospital should strengthen the standard management of medical behavior,strictly control the unreasonable use of drugs and non-standard diagnosis and treatment items,and avoid excessive use of drugs and excessive examination;Through various ways to improve the professional ability and technical level of doctors,shorten the average number of days in hospital,reduce the cost of diagnosis and treatment,strengthen the management of each link in the hospitalization process,and finally form a scientific medical cost management method. |
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