علل مرگ و میر بیماران بستری در بیمارستان‌های تحت پوشش دانشگاه‌های علوم پزشکی استان سمنان بر اساس طبقه‌بندی بین‌المللی بیماری‌ها
محورهای موضوعی : -مدارک پزشکیمحمدعلی جهانی تیجی 1 , فاطمه زهرا اسکندری 2 , شهربانو محمودجانلو 3 , قهرمان محمودی 4
1 - دانشیار، مرکز تحقیقات عوامل اجتماعی موثر بر سلامت، پژوهشکده سلامت، دانشگاه علوم پزشکی بابل، بابل، ایران
2 - کارشناس‌ارشد مدیریت خدمات بهداشتی و درمانی، دانشگاه علوم پزشکی سمنان، سمنان، ایران
3 - کارشناس‌ارشد مدیریت خدمات بهداشتی و درمانی، دانشگاه علوم پزشکی مازندران، ساری، ایران
4 - دانشیار، مرکز تحقیقات مدیریت بیمارستان، واحد ساری، دانشگاه آزاد اسلامی، ساری، ایران
کلید واژه: طبقه‌بندی بین‌المللی بیماری‌ها, بیمارستان‌ها, مرگ و میر, بیماران,
چکیده مقاله :
مقدمه: شناسایی روند و علل مرگ و میر می‌تواند مبنای برنامه‌ریزی و سیاست‌گذاری بهداشتی و درمانی در جامعه باشد. هدف از مطالعه حاضر تعیین علل مرگ ومیر بیماران بستری در بیمارستان بر اساس طبقه بندی بین‌المللی بیماری‌ها بوده است. روش پژوهش: این مطالعه توصیفی - تحلیلی به صورت گذشته‌نگر انجام شد. جامعه آماری پژوهش بیماران بسـتری فوت شده در بیمارستان‌های تحت پوشش دانشگاه‌های علوم پزشکی استان سمنان از سال 1390 لغایت 1394 بوده است. روش نمونه‌گیری سرشماری بوده، ابزار جمع‌آوری داده‌ها چک‌لیستی بود که از سامانه ثبت مرگ معاونت درمان دانشگاه‌ها استخراج گردید. داده‌ها پس از جمع‌آوری در نرم‌افزار20 SPSSوارد و سپس با استفاده از آزمون آماری در سطح معنی‌داری p≤0.05 تحلیل گردید. یافته‌ها: تعداد مرگ ثبت شده 8270 مورد ، تعداد مرگ و میر شهرنشینان (76/3 %)6307 مورد، مردان (53/8 %)4450 مورد بوده است. بیشترین فراوانی مرگ و میربه ترتیب برای بیماری‌های دستگاه گردش خون (38/7%) 3201، سرطان ها (15/5%) 1278 و بیماری‌های دستگاه تنفسی (10/5%) 865 مورد بوده است. بین مرگ و میرها با جنسیت، محل سکونت و رده‌های سنی رابطه معنی‌داری وجود داشته است (p<0.001). بین فصول مختلف از لحاظ مرگ و میر ارتباط معنی داری وجود داشته است (p<0.001). نتیجه‌گیری: بیماری‌های مزمن و غیرواگیر اصلی‌ترین عامل مرگ و میر شناخته شده‌اند که سیاست‌گذاران نظام سلامت می‌توانند از طریق برنامه‌های غربالگری، توانمندسازی مردم و وضع قوانین و مقررات در راستای ترویج شیوه زندگی سالم ، زمینه کاهش این بیماری‌ها را فراهم سازند.
Introduction: Identifying the trends and causes of mortality can be a base for health-care policy-making and planning in society. This study aimed at identifying the causes of the mortality of hospitalized patients based on International Classification of Diseases. Methods: This retrospective study was a descriptive-analytical one. Research population included all inpatients died in hospitals under supervision of Semnan University of Medical Sciences during a 5-year period (2011-2016). Sampling was done as the senses and data were collected by a checklist extracted from death registration system of the Treatment Deputy of the university. Data were analyzed in SPSS by applying statistical approaches in the significant level of p≤ 0.05. Results: 8,270 hospital mortalities were registered during the period. 6,370 (76.3%) of dead patients were burghers and 4,450 (53.8%) were male. The most frequent causes of the mortality were cardiovascular diseases (3,201, 38.7%), cancers (1,287, 15.5%), and respiratory diseases (865, 10.5%). There were significant differences among the mortality rates according to patients' gender, residences, and age ranges (p< .001). Conclusion: Chronic and non-communicable diseases were the main causes of the mortality. Health policy-makers can decrease in these diseases by applying screening programs, empowering people and endorsing regulations on safety life style and so on. Keywords: Hospitals, International Classification of Diseases (ICD10), Mortality, Patients, Iran.
1- Mahmoudi GA, Astaraki P, Anbari K. Epidemiolgical Survey of Mortality Rate in Patients Admitted to Shohada Hospital of Khorramabad in 2011. IJFM, 2014; 20(1): 393-400. [Persian]
2- Amani F, Kazemnejad A, Habibi R, Hajizadeh E. Pattern Of Mortality Trend In Iran During 1970-2009. Journal of Gorgan University of Medical Sciences, 2011; 12(4): 85-90. [Persian]
3- Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet, 2012; 380(9859): 2095-128.
4- Wang H, Dwyer-Lindgren L, Lofgren KT, Rajaratnam JK, Marcus JR, Levin-Rector A, et al. Age-specific and sex-specific mortality in 187 countries, 1970–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 2012; 380(9859): 2071-94.
5- Faghihi F, Jafari N, Akbari Sari A, Nedjat S, Hosainzadeh M. Trend of Mortality Rate and Causes of Death in Qazvin Province, 2004-2008. IJFM, 2015; 21(1): 35-42. [Persian]
6- Salomon JA, Wang H, Freeman MK, Vos T, Flaxman AD, Lopez AD, et al. Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden Disease Study 2010. The Lancet, 2012; 380(9859): 2144-62.
7- Jafar TH, Haaland BA, Rahman A, Razzak JA, Bilger M, Naghavi M, et al. Non-communicable diseases and injuries in Pakistan: strategic priorities. The Lancet, 2013; 381(9885): 2281-90.
8- Murray CJ, Richards MA, Newton JN, Fenton KA, Anderson HR, Atkinson C, et al. UK health performance: findings of the Global Burden of Disease Study 2010. The lancet, 2013; 381(9871): 997-1020.
9- Aryaee M, Dortaj A, Naderi N, Ebrahimi R. The Compliance Of The Records Of The Death Certificate With The Medical Records Of The Deceased And The Views Of The Certificate Issuers In This Regard At Kerman Teaching Hospitals. Monitoring, 2011; 10(2): 167-73. [Persian]
10- Farzandipour M, Sheikhtaheri A. Evaluation Of Factors Influencing Accuracy Of Principal Procedure Coding Based On Icd-9-Cm: An Iranian Study. Perspectives In Health Information Management/Ahima, American Health Information Management Association, 2009; 6(5): 112-28. [Persian]
11- Nojilana B, Groenewald P, Bradshaw D, Reagon G. Quality of cause of death certification at an academic hospital in Cape Town, South Africa. SAMJ: South African Medical Journal, 2009; 99(9): 648-52.
12- Myers KA, Farquhar DR. Improving the accuracy of death certification. Canadian Medical Association Journal, 1998; 158(10): 1317-23.
13- World Health Organization. ICD‐10 2003 Version. 2011. Available at. http://www. who. Int /entity/ classifications /icd/ICD‐10_2nd_ed_volume2.pdf. Accessed 21 December 2011
14- Dimick C. Mortality coding marks 10 years of ICD-10. Journal of AHIMA, 2009; 80(7): 30-3.
15- Moghadamnia A A, Jahani M A, Bijani A, Yaminfirooz M, Naghshineh A, Mohammadnia K. Evaluation Of Performance Indicators And Frequency Of Patient Referrals In The Hospitals Affiliated To Babol University Of Medical Sciences In 2013. Journal Of Babol University Of Medical Sciences (JBUMS), 2016; 18(5): 61-9. [Persian]
16 -Joshi R, Lodhe R, Agrawal S, Jain A. Hospital based infectious disease related proportional mortality study. Journal of global infectious diseases, 2014; 6(1): 10-6.
17- Singh RB, Singh V, Kulshrestha SK, Singh S, Gupta P, Kumar R, et al. Social class and all-cause mortality in an urban population of North India. Acta cardiologica, 2005; 60(6): 611-7.
18- Gholami Taremsari M. Study To Determine The Causes Of Death And Life Expectancy Kohgiloyeh Rural Population In 2005. Tehran: Islamic Azad University; 2005. [Persian]
19- Azami H, Khatony A, Abdi A. The Incidence And Associated Factors To Mortality In Critical Care Patients Of Imam Reza Hospital In Kermanshah, Iran In 2014. International Research Journal of Applied and Basic Sciences, 2015; 9(11): 2065-8. [Persian]
20- Misganaw A, Mariam DH, Araya T, Ayele K. Patterns Of Mortality In Public And Private Hospitals Of Addis Ababa, Ethiopia. BMC Public Health, 2012; 12(1): 1007-15.
21- Hasibi M, Soudbakhsh A, Abadi Z, Mehdipoor P. Mortality rate of infectious disease in relation to holidays: Three year study in Imam Khomeini Hospital. Tehran University Medical Journal TUMS Publications, 2008; 65(10): 50-54. [Persian]
22 -Fereshtehnejad SM, Asadi LM, Moradi LM, Vaez MMR, Motevalian SA, Eshagh AM. Estimation Of Life Expectancyandits Association With Social Determinants Of Health (Sdh) In Urban Population Of Different Districts Of Tehran In 2008 (Urban Heart Study). teb, 2010; 19(2): 25-40. [Persian]
23- Ansary LA, Esmaeil SA, Adib YA. Causes Of Death Certification Of Adults: An Exploratory Cross-Sectional Study At A University Hospital In Riyadh, Saudi Arabia. Annals of Saudi medicine, 2012; 32(6): 615-22. [Persian]
24- Ahmadi A, Shojaee M. Estimation of life expectancy changes in Chaharmahal va Bakhtiyary Province, Iran, during 2005-2009. Journal of Shahrekord Uuniversity of Medical Sciences, 2011; 13(4): 74-80. [Persian]
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1- Mahmoudi GA, Astaraki P, Anbari K. Epidemiolgical Survey of Mortality Rate in Patients Admitted to Shohada Hospital of Khorramabad in 2011. IJFM, 2014; 20(1): 393-400. [Persian]
2- Amani F, Kazemnejad A, Habibi R, Hajizadeh E. Pattern Of Mortality Trend In Iran During 1970-2009. Journal of Gorgan University of Medical Sciences, 2011; 12(4): 85-90. [Persian]
3- Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet, 2012; 380(9859): 2095-128.
4- Wang H, Dwyer-Lindgren L, Lofgren KT, Rajaratnam JK, Marcus JR, Levin-Rector A, et al. Age-specific and sex-specific mortality in 187 countries, 1970–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 2012; 380(9859): 2071-94.
5- Faghihi F, Jafari N, Akbari Sari A, Nedjat S, Hosainzadeh M. Trend of Mortality Rate and Causes of Death in Qazvin Province, 2004-2008. IJFM, 2015; 21(1): 35-42. [Persian]
6- Salomon JA, Wang H, Freeman MK, Vos T, Flaxman AD, Lopez AD, et al. Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden Disease Study 2010. The Lancet, 2012; 380(9859): 2144-62.
7- Jafar TH, Haaland BA, Rahman A, Razzak JA, Bilger M, Naghavi M, et al. Non-communicable diseases and injuries in Pakistan: strategic priorities. The Lancet, 2013; 381(9885): 2281-90.
8- Murray CJ, Richards MA, Newton JN, Fenton KA, Anderson HR, Atkinson C, et al. UK health performance: findings of the Global Burden of Disease Study 2010. The lancet, 2013; 381(9871): 997-1020.
9- Aryaee M, Dortaj A, Naderi N, Ebrahimi R. The Compliance Of The Records Of The Death Certificate With The Medical Records Of The Deceased And The Views Of The Certificate Issuers In This Regard At Kerman Teaching Hospitals. Monitoring, 2011; 10(2): 167-73. [Persian]
10- Farzandipour M, Sheikhtaheri A. Evaluation Of Factors Influencing Accuracy Of Principal Procedure Coding Based On Icd-9-Cm: An Iranian Study. Perspectives In Health Information Management/Ahima, American Health Information Management Association, 2009; 6(5): 112-28. [Persian]
11- Nojilana B, Groenewald P, Bradshaw D, Reagon G. Quality of cause of death certification at an academic hospital in Cape Town, South Africa. SAMJ: South African Medical Journal, 2009; 99(9): 648-52.
12- Myers KA, Farquhar DR. Improving the accuracy of death certification. Canadian Medical Association Journal, 1998; 158(10): 1317-23.
13- World Health Organization. ICD‐10 2003 Version. 2011. Available at. http://www. who. Int /entity/ classifications /icd/ICD‐10_2nd_ed_volume2.pdf. Accessed 21 December 2011
14- Dimick C. Mortality coding marks 10 years of ICD-10. Journal of AHIMA, 2009; 80(7): 30-3.
15- Moghadamnia A A, Jahani M A, Bijani A, Yaminfirooz M, Naghshineh A, Mohammadnia K. Evaluation Of Performance Indicators And Frequency Of Patient Referrals In The Hospitals Affiliated To Babol University Of Medical Sciences In 2013. Journal Of Babol University Of Medical Sciences (JBUMS), 2016; 18(5): 61-9. [Persian]
16 -Joshi R, Lodhe R, Agrawal S, Jain A. Hospital based infectious disease related proportional mortality study. Journal of global infectious diseases, 2014; 6(1): 10-6.
17- Singh RB, Singh V, Kulshrestha SK, Singh S, Gupta P, Kumar R, et al. Social class and all-cause mortality in an urban population of North India. Acta cardiologica, 2005; 60(6): 611-7.
18- Gholami Taremsari M. Study To Determine The Causes Of Death And Life Expectancy Kohgiloyeh Rural Population In 2005. Tehran: Islamic Azad University; 2005. [Persian]
19- Azami H, Khatony A, Abdi A. The Incidence And Associated Factors To Mortality In Critical Care Patients Of Imam Reza Hospital In Kermanshah, Iran In 2014. International Research Journal of Applied and Basic Sciences, 2015; 9(11): 2065-8. [Persian]
20- Misganaw A, Mariam DH, Araya T, Ayele K. Patterns Of Mortality In Public And Private Hospitals Of Addis Ababa, Ethiopia. BMC Public Health, 2012; 12(1): 1007-15.
21- Hasibi M, Soudbakhsh A, Abadi Z, Mehdipoor P. Mortality rate of infectious disease in relation to holidays: Three year study in Imam Khomeini Hospital. Tehran University Medical Journal TUMS Publications, 2008; 65(10): 50-54. [Persian]
22 -Fereshtehnejad SM, Asadi LM, Moradi LM, Vaez MMR, Motevalian SA, Eshagh AM. Estimation Of Life Expectancyandits Association With Social Determinants Of Health (Sdh) In Urban Population Of Different Districts Of Tehran In 2008 (Urban Heart Study). teb, 2010; 19(2): 25-40. [Persian]
23- Ansary LA, Esmaeil SA, Adib YA. Causes Of Death Certification Of Adults: An Exploratory Cross-Sectional Study At A University Hospital In Riyadh, Saudi Arabia. Annals of Saudi medicine, 2012; 32(6): 615-22. [Persian]
24- Ahmadi A, Shojaee M. Estimation of life expectancy changes in Chaharmahal va Bakhtiyary Province, Iran, during 2005-2009. Journal of Shahrekord Uuniversity of Medical Sciences, 2011; 13(4): 74-80. [Persian]