目的: 研究北京市慢性阻塞性肺疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease, AECOPD)女性住院患者的流行病学特征及住院费用。方法: 选择2013—2020年北京市AECOPD女性患者的住院医保数据进行回顾性分析, 记录其年龄分布、合并症情况、住院时间、住院费用以及流行病学特征(时间和空间分布特点)。结果: 纳入166家医院57 911例住院患者, 平均年龄(78.84±8.59)岁, 80~89岁患者(49.06%)最多, 70~79岁(31.08%)次之, 18~50岁(0.41%)最少。合并冠心病、高血压以及心力衰竭的患者占比分别为30.60%、30.52%和26.54%。每日住院人次的中位数为18(IQR: 16), 且2013—2020年8年中总体呈增长趋势, 2015年开始明显增加, 上升趋势持续至2019年, 2020年则有所回落。冬春季住院人次占比(54.09%)高于夏秋季(45.91%)。各市辖区总住院人次占比排在前三位的分别为西城区(14.18%)、朝阳区(14.12%)和丰台区(13.47%); 城市西部、中心城区和东北部住院人次密度较高, 而近郊区住院人次密度则相对较低。AECOPD女性患者的住院时间和住院费用中位数分别为12 d和20 648.37元。城区患者的住院时间和住院费用均高于郊区, 差异有统计学意义(P＜0.001)。西药费用是住院总费用的主要部分(33.32%)。研究时段住院费用总体呈先增长后降低随之趋于稳定的变化特征, 不同合并症患者的住院费用差异明显。结论: 北京市AECOPD女性住院患者以70岁及以上老年患者为主, 常合并心血管疾病, 主要在冬春季节发病且有地域差异, 其住院费用与患者年龄、合并症以及所在地区密切相关。

Objective: To study epidemiological characteristics and hospitalization costs of female inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing. Methods: A retrospective study was conducted to analyze electronic hospitalization summary reports of female inpatients with AECOPD in Beijing from 2013 to 2020. Clinical characteristics (age distribution and comorbidities), epidemiological characteristics (temporal and spatial distribution characteristics), hospi-talization times and costs of patients were described. Results: A total of 57 911 subjects in 166 hospitals were included in this study, with a mean age of (78.84±8.59) years and the highest number of patients aged 80-89 years (49.06%), followed by patients aged 70-79 years (31.08%), and the lowest number of patients under 50 years (0.41%). The proportions of patients with coronary heart disease, hypertension and heart failure were 30.60%, 30.52% and 26.54% respectively. The median number of daily hospitalizations during the study period was 18 (IQR: 16). The number of daily hospitalizations for AECOPD showed an overall growth trend over the eight years from 2013 to 2020, starting to increase significantly in 2015 and continuing to increase until 2019, then followed by a decline in 2020. The proportion of inpatient admissions was higher in winter and spring (54.09%) than that in summer and autumn (45.91%). The top three districts in terms of the proportion of total inpatient admissions were Xicheng district (14.18%), Chaoyang district (14.12%) and Fengtai district (13.47%). The density of inpatients was relatively high in the western regions, central urban areas and northeastern regions of the city, while the density of inpatients was relatively low in the near suburbs. The median number of hospital days for female patients with AECOPD was 12 days, and the median hospital costs was CNY 20 648.37. Patients from urban areas had longer hospitalization times and higher hospitalization costs than those from suburban areas (P < 0.001). Western medicine expenses accounted for the largest proportion of total hospital expenses (33.32%). During the study period, hospitalization costs exhibited an overall pattern of initial growth, followed by subsequent decline, eventually stabilizing. The differences in hospitalization costs among the patients with different comorbidities were significant. Conclusion: Female hospitalized patients with AECOPD in Beijing were older than 70 years, often complicated by cardiovascular disease. AECOPD occurred mainly in winter and spring, with regional differences. The hospitalization costs were closely associated with the patients' age, comorbidities, and the geographicical region.