Trends in hospitalization for endocrine, nutritional and metabolic diseases in China: a national analysis from 2010 to 2021

With the rapid socioeconomic transformation and accelerating population aging in China, endocrine, nutritional and metabolic diseases have become an increasingly prominent major public health issue in the country, with a continuously rising disease burden. A systematic assessment of the long-term trends in hospitalization burden, as well as population and urban-rural distribution characteristics of these diseases, has important practical significance for optimizing the allocation of health resources and improving chronic disease prevention and control strategies. This study analyzed the long-term trends in hospitalization volume, disease composition, in-hospital mortality, average length of hospital stay, and average cost per hospitalization for endocrine, nutritional and metabolic diseases in general hospitals in China from 2010 to 2021, with subgroup analysis by urban-rural setting, age and gender, to provide data support for the prevention and control of these diseases and medical service management. Data were extracted from the China Health Statistics Yearbook from 2010 to 2021, covering relevant data of inpatients with endocrine, nutritional and metabolic diseases in general hospitals nationwide. The Cochran-Armitage trend test was used to analyze the changing trends of categorical variables (in-hospital mortality rate, age composition ratio, etc.), and the linear regression model was employed to analyze the changing trends of continuous variables (number of hospitalizations, average length of stay, average hospitalization cost, etc.). All hospitalization costs were adjusted to the constant price of 2021 using the Consumer Price Index (CPI). From 2010 to 2021, the total number of hospital discharges for endocrine, nutritional and metabolic diseases in China increased from 1,045,037 to 2,780,177, and its proportion in total hospital discharges rose from 2.91% to 3.43% ( \\(\\:P\\) for trend < 0.001). The in-hospital mortality decreased from 0.50% to 0.18% ( \\(\\:P\\) for trend < 0.001). The average length of hospital stay shortened from 11.7 days to 8.2 days ( \\(\\:P\\) for trend < 0.001), while the adjusted average cost per hospitalization increased from 6,442 yuan to 8,474 yuan ( \\(\\:P\\) for trend < 0.001). The urban-rural ratio of hospitalization volume decreased from 5.11 to 1.78 ( \\(\\:P\\) for trend = 0.0164), indicating a significant narrowing of the urban-rural gap. Inpatients were mainly middle-aged and elderly populations, with the proportion of patients aged ≥ 60 years increasing from 42.8% to 44.0% ( \\(\\:P\\) for trend < 0.001). From 2010 to 2021, the hospitalization burden of endocrine, nutritional and metabolic diseases in China continued to increase significantly. Over the same period, in-hospital mortality fell, average length of stay shortened, and the gap in inpatient service utilization between urban and county-level settings narrowed gradually. The disease burden is distinctly concentrated in older age groups, with older women accounting for a higher share of inpatients. To scientifically address the public health challenges posed by these diseases, further efforts should strengthen population-wide primary prevention, optimize whole-course chronic disease management, and continuously advance the development of the tiered diagnosis and treatment system. Targeted intervention strategies should be developed for priority populations such as older women.