老年骨质疏松性髋部骨折患者住院费用的研究
发布时间：2019-01-09 15:06
【摘要】：目的:通过回顾性地收集1994～2014年广州市两所三甲医院(广东省中医院、中山大学孙逸仙纪念医院)共6间分院老年髋部骨折患者的资料(包括患者年龄、性别、骨折类型、住院时间、住院费用等)来分析老年骨质疏松性髋部骨折患者的基本流行病学特征、住院费用构成情况以及变化趋势。方法:从广东省中医院和中山大学孙逸仙纪念医院等6间分院病案信息管理系统获得于1994年1月～2014年12月收治的骨质疏松性髋部骨折患者(股骨颈骨折或股骨粗隆间骨折)住院期间的病例资料,包括:患者住院号、姓名、性别、年龄、入院日期、出院日期、住院天数、临床诊断、是否手术、住院总费用、床位费、西药费、中药费、检查费、治疗费、手术费、化验费、输血及输氧费、护理费及其它费用等。结果:在过去21年,随着我国社会老龄化及城镇化的进展,髋部骨折的住院人数有了巨大的提升。本研究表明,患者平均年龄为(76.55±9.60,中位数78)岁,男性(75.47±9.93,中位数78)岁,女性(77.12±9.37,中位数77)岁,其中男女比例为1:1.92。髋部骨折的平均发病年龄由(73.57±8.55,中位数74)提升至(77.93± 10.29,中位数80)岁。平均住院天数为(22.59±12.28,中位数20)天,在不同骨折类型和性别之间未见统计学差异,住院天数也从1994年的(30.55± 16.34,中位数27)天减少至2014年的(16.09±7.34,中位数15)天。住院人数分布最多的年龄组是75～79岁组(21.29%),其次是80～84岁组(20.18%)、70～74岁组(15.7%)。在50～84岁之间的患者股骨颈骨折多于股骨转子间骨折,而年龄≥85岁的患者却少于股骨转子间骨折。在85～89岁之间,两种类型的骨折有着几乎相同的发病率。平均的住院费用为(26619.17±20278.12,中位数23231.46)元,股骨颈骨折患者住院费用为(28579.74±21733.29,中位数25603.54)元,转子间骨折患者住院费用为(24257.83±18096.40,中位数21711.52)元。住院费用每年以10.16%速度在增长,主要包括治疗费(术中使用的材料和内植物费用,手术室的常规处置费)42.72%,药物费24.27%,手术费13.07%,病房费4.44%,影像检查费4.45%,检验费4.86%,护理费4.10%,输血及输氧费2.09%。结论:研究表明,随着我国经济的增长,老年骨质疏松性髋部骨折患者的住院费用不断增多。其中,手术治疗费、术中使用的器械费(内植物和材料)及药物费占了主要部分。根据患者的具体情况,选择合理的治疗方案将有助于减少髋部骨折的住院费用。
[Abstract]:Objective: to collect retrospectively the data of elderly hip fracture patients (including age, sex, fracture type) in two third Class A Hospitals (Guangdong Provincial Hospital of Chinese Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University) in Guangzhou from 1994 to 2014. To analyze the basic epidemiological characteristics, the composition of hospitalization expenses and the trend of change in elderly patients with osteoporotic hip fracture. Methods: patients with osteoporotic hip fracture (femoral neck fracture or femur) were obtained from 6 departments of Guangdong traditional Chinese Medicine Hospital and Sun Yat-sen Memorial Hospital, Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 1994 to December 2014. Intertrochanteric fracture) case data during hospitalization, Including: patient's hospitalization number, name, sex, age, date of admission, date of discharge, length of stay, clinical diagnosis, operation, total cost of hospitalization, bed fee, western medicine fee, Chinese medicine fee, examination fee, treatment fee, operating fee, laboratory fee, Transfusion and oxygen transfusions, nursing and other expenses, etc. Results: in the past 21 years, the number of hip fracture hospitalizations has increased greatly with the development of aging and urbanization. The average age of the patients was (76.55 卤9.60, median 78), male (75.47 卤9.93) and female (77.12 卤9.37, median 77) years. The ratio of male to female was 1: 1.92. The mean onset age of hip fractures increased from (73.57 卤8.55, median 74) to (77.93 卤10.29, median 80) years. The average hospitalization days were (22.59 卤12.28) days (median 20) days, and there was no statistical difference between different fracture types and genders. The number of hospitalization days decreased from (30.55 卤16.34) days in 1994 to (16.09 卤7.34) days in 2014. Median 15) days. The age group of 75 ~ 79 years old (21.29%), followed by 80 ~ 84 years old group (20.18%), 70 ~ 74 years old group (15.7%). The number of femoral neck fractures in patients aged 50 to 84 years was more than that of intertrochanteric fractures, while the number of patients aged over 85 years was less than that of femoral intertrochanteric fractures. Between the ages of 85 and 89, the two types of fractures had almost the same incidence. The average hospitalization expenses were (26619.17 卤20278.12) yuan, (28579.74 卤21733.29) yuan and (24257.83 卤18096.40) yuan, respectively, and those of the patients with femoral neck fracture were (28579.74 卤21733.29) yuan and (24257.83 卤18096.40) yuan, respectively. The median is $21711.52). The cost of hospitalization is increasing by 10.16% per year, mainly including the cost of treatment (the cost of materials and plants used during the operation, the cost of conventional disposal of operating room) 42.72, the cost of medicine 24.27, the cost of operation 13.07. The ward fee was 4.44, the image examination fee was 4.45, the examination fee was 4.86, the nursing fee was 4.10 and the blood transfusion and oxygen transfusion fee was 2.09. Conclusion: with the economic growth in China, the hospitalization costs of elderly patients with osteoporotic hip fracture are increasing. The cost of surgical treatment, the cost of instruments used during operation (implants and materials) and the cost of drugs accounted for the main part. According to the patient's condition, choosing reasonable treatment will help to reduce the hospitalization cost of hip fracture.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R683;R197.323
，
本文编号：2405785
[Abstract]:Objective: to collect retrospectively the data of elderly hip fracture patients (including age, sex, fracture type) in two third Class A Hospitals (Guangdong Provincial Hospital of Chinese Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University) in Guangzhou from 1994 to 2014. To analyze the basic epidemiological characteristics, the composition of hospitalization expenses and the trend of change in elderly patients with osteoporotic hip fracture. Methods: patients with osteoporotic hip fracture (femoral neck fracture or femur) were obtained from 6 departments of Guangdong traditional Chinese Medicine Hospital and Sun Yat-sen Memorial Hospital, Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 1994 to December 2014. Intertrochanteric fracture) case data during hospitalization, Including: patient's hospitalization number, name, sex, age, date of admission, date of discharge, length of stay, clinical diagnosis, operation, total cost of hospitalization, bed fee, western medicine fee, Chinese medicine fee, examination fee, treatment fee, operating fee, laboratory fee, Transfusion and oxygen transfusions, nursing and other expenses, etc. Results: in the past 21 years, the number of hip fracture hospitalizations has increased greatly with the development of aging and urbanization. The average age of the patients was (76.55 卤9.60, median 78), male (75.47 卤9.93) and female (77.12 卤9.37, median 77) years. The ratio of male to female was 1: 1.92. The mean onset age of hip fractures increased from (73.57 卤8.55, median 74) to (77.93 卤10.29, median 80) years. The average hospitalization days were (22.59 卤12.28) days (median 20) days, and there was no statistical difference between different fracture types and genders. The number of hospitalization days decreased from (30.55 卤16.34) days in 1994 to (16.09 卤7.34) days in 2014. Median 15) days. The age group of 75 ~ 79 years old (21.29%), followed by 80 ~ 84 years old group (20.18%), 70 ~ 74 years old group (15.7%). The number of femoral neck fractures in patients aged 50 to 84 years was more than that of intertrochanteric fractures, while the number of patients aged over 85 years was less than that of femoral intertrochanteric fractures. Between the ages of 85 and 89, the two types of fractures had almost the same incidence. The average hospitalization expenses were (26619.17 卤20278.12) yuan, (28579.74 卤21733.29) yuan and (24257.83 卤18096.40) yuan, respectively, and those of the patients with femoral neck fracture were (28579.74 卤21733.29) yuan and (24257.83 卤18096.40) yuan, respectively. The median is $21711.52). The cost of hospitalization is increasing by 10.16% per year, mainly including the cost of treatment (the cost of materials and plants used during the operation, the cost of conventional disposal of operating room) 42.72, the cost of medicine 24.27, the cost of operation 13.07. The ward fee was 4.44, the image examination fee was 4.45, the examination fee was 4.86, the nursing fee was 4.10 and the blood transfusion and oxygen transfusion fee was 2.09. Conclusion: with the economic growth in China, the hospitalization costs of elderly patients with osteoporotic hip fracture are increasing. The cost of surgical treatment, the cost of instruments used during operation (implants and materials) and the cost of drugs accounted for the main part. According to the patient's condition, choosing reasonable treatment will help to reduce the hospitalization cost of hip fracture.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R683;R197.323
，
本文编号：2405785
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