目的通过石家庄市某医院门急诊量与API的关系研究,探讨2013年1月灰霾事件对门急诊量的影响。方法门急诊量数据来源于石家庄市某三甲综合性医院,空气污染指数(API)来自当地环境保护局网站,气象数据来自天气网。研究时间包括2012年9月—2013年1月(T1序列)和2011年9月—2012年2月(T2序列)。通过控制两个序列门急诊的自然增长,计算得到每日门急诊量的百分增量。将两年度2个数据序列各分四个时段(9—10月、11月、12月、次年1月)进行API与门急诊量的Poisson回归分析。结果石家庄市的API于2012年12月23日开始升高,2013年1月5日达500;2012年12月30日—2013年1月16日,社区医疗科、心内科、内分泌科、儿科门诊、呼吸内科、普外科门诊、儿科急诊和急诊科出现就诊高峰,相应的百分增量为24%-253%。Poisson回归分析进一步证实,上述科室2013年1月危险度高于其它时段,且具有统计学意义(P〈0.05),API每升高1个四分位数间距,每日门诊量或急诊量增加6.8%-30.1%。结论灰霾期间医院门急诊量明显升高,空气污染与医院门急诊量的增加有相关关系,季节影响、流感流行均不足以解释相关门诊量和急诊量的升高。
Objective To investigate the association between API and hospital outpatient and emergency room visits during 2013 haze episode in Shijiazhuang. Methods Daily outpatient and emergency visits data were collected from a comprehensive hospital within Shijiazhuang downtown area. Data of API were gained from local environmental protection agency and data of temperature were from China Weather website. The observation period was from Sep.2012 to Jan.2013(T1) and the same period from previous year(T2). We first calculated the increase of daily outpatient visit of Sep.2012-Jan.2013 against Sep.2011- Jan.2012.Then, we used Poisson regression model to estimate the relative risks of air pollution to daily outpatient visit. Results Since 23 Dec.2012, API had been climbing in Shijiazhuang, which reached 500 on 5 Jan.2013. During the period from 30 Dec.2012 to16 Jan.2013, the number of outpatient visits to various department were increased greatly. The involved departments included community medicine, cardiovascular disease, endocrine, pediatrics, respiratory and surgery, emergency pediatrics and general emergency. The corresponding peak of increased daily visits ranged 24%-253%. Poisson regression analysis suggested that there were significant association between API and the above outpatient and emergency visits during event. The daily outpatient and emergency visits of above department increased 6.8%-30.1% with an interquartile range increase of API,which were appreciably higher than those other periods. Conclusion The considerable increase in outpatient and emergency visits are observed in Shijiazhuang during haze period, which are associated with the high levels of air pollution, and unlikely to be explained by weather, coincidental epidemic factors.