ABSTRACT
Objective:To analyze the changes of hospitalization rates in different regions, medical institutions and populations in China from 2009 to 2019, so as to provide reference for the country to make relevant decisions.Methods:The data of China′s health statistical yearbook from 2009 to 2019 were obtained, and the changes of hospitalization rate and the number of hospitalizations per 100 outpatient and emergency admissions in different regions and medical institutions, and hospitalization rate of different populations and different diseases were analyzed. Descriptive analysis and frequency analysis were used.Results:The hospitalization rate in China continued to rise, from 9.95% in 2009 to 19.03% in 2019. Among them, the hospitalization rate in the eastern, central and western regions increased from 9.7%, 9.9% and 10.8% to 17.0%, 19.3% and 21.5% respectively, with an average annual growth rate of 5.8%, 6.9% and 7.1% respectively. The number of inpatients in public hospitals increased by 1.2 times and that in private hospitals increased by 4.5 times. The number of inpatients in tertiary, secondary and primary hospitals and primary medical institutions increased by 292.9%, 80.8%, 166.4% and 4.5% respectively.From 2009 to 2018, the number of hospitalizations per 100 outpatient and emergency admissions in the hospital increased from 4.5 to 5.7, and decreased to 5.6 in 2019. The increase of hospitalization rate of urban residents was less than that of rural residents. The hospitalization rate of residents aged 0-4 and ≥55 years increased the fastest. In recent years, the discharge diseases were mainly common diseases, chronic diseases and frequently occurring diseases, including pneumonia, acute upper respiratory tract infection, diabetes, and hypertension.Conclusions:During the ten years of medical reform, the hospitalization rate in China has continued to rise, and the overall trend is reasonable. There are significant differences in the changes of hospitalization rates between urban and rural areas, regions and populations in China.
ABSTRACT
Aims: To study the trends in admission for diseases of the appendix and to attempt to present a potential basis for the observed (complex) age-dependent trends and etiologies. Study Design: Longitudinal study of admissions relating to the appendix with analysis by age and gender. Place and Duration of Study: Admissions for diseases affecting the appendix for the residents of England over the period 2000/01 to 2012/13. Methodology: Retrospective application of age-standardized admission rates based on 2012/13 as the base year to determine what proportion of the increase in admissions is due to demography or to non-demographic forces. Synthesis of available literature covering diseases of the appendix to propose possible causes for the increase in admissions. Results: Based on admissions in 2012/13 diseases of the appendix cost the NHS in England around £107 million per annum (roughly £2 per head of population per annum). Admission rates peak at age 17 but have been increasing over the past 14 years in adults but not children. The rate of increase escalates with age and is more rapid in females. The trend for females shows far higher volatility than that for males and both show some degree of cyclic behavior. Depending on age, demographic change can only explain between 20% and 40% of the long-term increase. Social and health service factors are unlikely to explain this gap. Conclusion: An immune/infectious basis for increasing admission rates appears most likely. A possible role for the immune modulating herpes virus, cytomegalovirus (CMV), is discussed in the context of a potential linkage between infection with multiple agents (called the infectious burden) and the development of multiple morbidity. Both of which increase with age and are amenable to manipulation by CMV. The suggested mechanism may also provide insight into why the rates for admission of certain medical diagnoses are increasing far faster than due to demographic change.