社区老年人跌倒的流行病学特征及医疗负担分析

目的了解社区老年人跌倒的流行病学特征及医疗负担。方法对居住在长宁区某2个居委会的1 690名老年人进行监测,对发生跌倒的老年人进行跟踪调查。结果监测到304例跌倒老人,男性86人（28.3%）,女性218人（71.7%）,平均（75.14±8.34）岁。跌倒发生在家中占41.78%,家外小区内占21.71%,小区以外占36.51%;不同地点跌倒老人自身原因的构成差异有统计学意义（χ2=47.83,P〈0.001）,在家中因头昏（10.2%）和不小心（74.0%）跌倒为主,而在小区内和小区以外跌倒均以不小心（87.9%,86.5%）为主;不同地点跌倒老人的环境原因的构成差异有统计学意义（χ2=115.67,P〈0.001）,在家中因没有保护措施（48.4%）跌倒为主,而在小区内跌倒以地面不平（32.3%）和没有保护措施（32.3%）为主,小区以外以路滑（24.3%）和地面不平（35.1%）为主。跌倒老年人中,57.9%去医院就诊,住院率为14.1%;最常见的受伤性质是浅表伤和骨折,分别占38.8%和32.2%;跌倒后的医疗花费中位数为700元;跌倒后有49.3%的老年人的运动能力受到不同程度的影响,尚有23.4%的老年人未采取正确的预防跌倒措施。结论社区老年人跌倒对健康危害较严重,造成一定的医疗负担,急需采取预防措施。

Study on the epidemiologic characteristics and medical burden of falls among older adults in community

Objective To study the epidemic characteristics and medical burden of falls among older adults in community.Methods Fall surveillance was carried out among 1 690 older adults from 2 communities of Changning district,Shanghai,those who fell with an injury were followed afterwards.Results There were 304 faller cases with mean age 75.14,including 86 males and 218 females.As for the fallers＇ intrinsic reasons, there was a significant difference between different places.As for environmental reasons,similar outcome was found.57.9% of the 304 fallers needed medical care and 14.1% of them were hospitalized.Fall in older adults mostly lead to fracture and surface injury.The median medical cost of falls was 700 RMB.49.3% of the 304 fallers had a more or less impact on their mobility.There were about 23.4% of the 304 fallers who did not take correct fall prevention measures.Conclusions Fall among older adults in community has a relatively severe impact on their health and lead to more or less medical burden.Fall prevention measures should be taken in community.