摘要
目的回顾分析过去10年（1998～2007）因骨质疏松性髋部骨折住院患者的基本情况与住院费用结构,了解骨质疏松性髋部骨折住院患者基本趋势及其所需要的医疗资源。方法2944例髋部骨折住院患者的基本情况来源于医院病案信息管理系统。采用描述性统计分析等方法,分析年龄50岁以上的患者的一般情况、住院时间与住院费用等。结果过去10年,髋部骨折的患者住院人数逐年增长,每年的女性患者人数均显著高于男性,男女患者总人数比为1∶1.94。患者平均年龄为（76.34±9.51）岁,平均住院天数（22.94±13.17）d。70～79岁与80～89岁年龄段的患者数最多,分别占总人数的38.69%和33.22%。粗隆间骨折与股骨颈骨折的变化表现为：低年龄段（50～79岁）股骨颈骨折显著多于粗隆间骨折,90岁以上粗隆间骨折显著多于股骨颈骨折。住院总费用平均为（2.20±1.51）万元（RMB）,其中粗隆间骨折（2.00±1.47）万元（RMB）,股骨颈骨折为（2.36±11.53）万元（RMB）。住院费用的构成为：治疗费（含内置物的费用）55%,药费23%（中药费11%、西药费12%）,其次为手术费7%,床位费5%与化验费4%。患者的住院总费用与住院天数密切相关,近10年来住院费用是逐年递增的,平均每年增加10.92%。结论老龄化使骨质疏松性髋部骨折逐年增多,所需医疗费用也逐年递增。绝经后骨质疏松及其骨折仍然是今后防治工作的重点。有效控制内置物以及药费是减少髋部骨折占用医疗资源,减轻患者经济负担的有效的途径。
Objective This is retrospective research for the osteoporotic hip fractures in the Second Affiliated Hospital of Guangzhou Traditional Chinese Medicine University in the past 10 years （1998 - 2007）. The purpose of this study was to analyze the hospitalized prevalence and estimate resource utilization associated with osteoporotic hip fractures, including hospital length of stay and inpatient costs in Guangzhou, China. Methods 2944 patients aged 50 years and older were hospitalized for primary diagnosis of hip fractures in our hospital in the past ten years. Completed data was obtained retrospectively from the hospital medical records. Clinical parameters such as the sexspecific, hospital length of stay, inpatient costs, and the constitutions of the inpatient costs were analyzed with multiple statistics methods and regressions. Results Over the 10-year study period the number of hospitalizations for hip fractures increased with a curve model. Male and female ratio was about 1 ： 1.94. Average age of patients was 76.34 ＋/- 9.51 years old. Average hospital length of stay was about 22.94 ＋/- 13.17 days with no significant difference between the male and female, the different years, and different diagnosis. The number of hospitalizations went to the top at the age of 70 to 79 years old （38.69%）, and then was the age of 80 - 89 years old （33.22%）. The number femoral neck fractures was significant more than that of intertroehanteric fractures at the ages of 50 - 79 years old, while it was significant less than that of intertrochanteric fractures in the patients aged 90 years and older. Average inpatient costs is about 22.05 ＋ / - 15.05 thousand Yuan （RMB）, femoral neck fractures is about 23.63 ＋ / - 15.28 thousand Yuan（RMB） and intertrochanteric fracture is 20.00 ＋ / - 14.70 thousand Yuan （RMB）. The constitution of the inpatient costs include 55 % treatment costs （include implants, materials used in the theatre and routinely care of the wound）, 23 % pharmacy intervention （ 11% Traditional Chinese Medicine and 12% West medicine）, 7% operation, 5% ward expenditure, 2% chemistry test and 1% radiology investigation. The inpatient cost went to a peak at the age of 60 - 69 years old and was significantly correlated with the hospital length of stay. The cost increased every year in the past 10 years by 10.92%. Conclusion These results emphasize the growing economic impact arising from the inpatient treatment osteoporotic hip fractures, most of which relates to treatment cost （include implants, materials used in the theatre and routinely care of the wound）, and pharmacy intervention. And it is always correlated to length of hospital stay. Cost control should be paid more attention to the implants and drugs.
出处
《中国骨质疏松杂志》
CAS
CSCD
2008年第10期708-712,732,共6页
Chinese Journal of Osteoporosis
基金
广东省科技计划(社会发展计划重大疾病防治)基金资助项目(2007B031506004)
关键词
髋部骨折
住院费用
骨质疏松
中医药疗法
Hip fracture
Hospital costs
Oestoporosis
Traditional Chinese medicine
