广州市1998-2007年3449例骨质疏松髋部骨折患者住院医疗资源分析

目的 了解骨质疏松性髋部骨折的基本趋势及其所需要的医疗资源情况.方法 3449例患者的基本情况来源于医院病案信息管理系统.统计分析年龄50岁以上因髋部骨折住院患者的一般情况、住院时间、住院费用及其结构等.结果 髋部骨折的住院人数逐年呈曲线增长,女性患者人数显著多于男性,男女总人数比为1:1.95(男性33.86%,女性66.14%).患者平均年龄(76.32±9.52)岁,最大年龄116岁.平均住院时间(23.59±13.48)d,各年龄组住院时间的差异无统计学意义.70～79岁与80～89岁年龄组人数最多,分别占总人数的38.45%和33.08%.股骨颈骨折与粗隆问骨折的比例为1.33:1.患者住院总费用平均(2.35±1.70)万元(RMB),其中粗隆问骨折(2.14± 1.59)万元,股骨颈骨折(2.51±1.76)万元.住院总费用中包括治疗费(含内置物费用,52%)、药费(25%)、手术费(6%)、床位费(5%)、放射及其他检查费(5%)、化验费(4%).近10年米总住院费用逐年递增,平均年增加6.18%,总费用与住院时间密切相关.结论 随着社会老龄化,骨质疏松髋部骨折逐年增多,医疗费用逐年递增;有效控制治疗费及药费是减少髋部骨折占用医疗资源,减轻患者与社会经济负担的有效途径.

A 10-year-review (1998-2007) on 3449 cases of osteoporotic hip fractures: trend of hospitalization and inpatient casts

Objective The purpose of this retrospective research was to analyze the trend of hospitalized prevalence in the past 10 years (1998 -2007) and to estimate resource utilization associated with osteoporotic hip fractures, including hospital length of stay and inpatient costs in Guangzhou,China. Methods 3449 patients aged 50 years and older,hospitalized for primary diagnose of hip fractures in both hospitals in the past ten years were included in our study. Completed data was obtained retrospectively from the hospital medical records. Clinical parameters such as sex-specifics, hospital length of stay, inpatient costs and the constitutions of the inpatient costs were analyzed with multiple statistics methods and regrcssions Results Over the 10-year study period, the number of hospitalizations for hip fractures increased with a curve model. Male and female ratio was 1:1.95 with an average age of the patients as76.32±9.52 years old. Average hospital length of stay was 23.59±13.48 days with no significant difference between males and females, years of admission and the different diagnoses. The number of hospitalization went to the top at the age of 70 to 79 years old (38.45%), followed by 80-89 years old(33.08 % ). Femoral neck fractures was significantly more than that of inter-trochanteric fractures in those patients aged 50 to 79 years (P<0.01 ) but less than those intertrochanteric fractures aged 90 years and older (P<0.05). Average inpatient costs is about 23.52±17.00 thousand Yuan (RMB) (femoral neck fractures is about 25.09±17.62 thousand Yuan and intertrochanteric fracture is 21.44±15.92 thousand Yuan) of which treatment costs (included implants, materials used in the theatre and routinely care of the wound) contributed 52 %, pharmacy intervention 25 %, operation 6 %, ward expenditure 5 %, radiology and physical investigation 5 %, and chemistry test 4 %. The inpatient cost went to a peak at the age of 60-69 years old and were significantly correlated with the hospital length of stay. The coat increased every year in the past 10 years by 6.18%. Conclusion These results emphasized that the growing economic impact arising from the inpatient treatment of ostcoporotic hip fractures and most of which related to treatment cost(include implants, materials used in the theatre and routinely care of the wound), and drugs and always correlated to length of hospital stay. Cost control should be paid more attention to the implants and drugs.