老年骨質疏松性髖部骨折患者住院費用的研究
發(fā)布時間：2019-01-09 15:06
【摘要】：目的:通過回顧性地收集1994～2014年廣州市兩所三甲醫(yī)院(廣東省中醫(yī)院、中山大學孫逸仙紀念醫(yī)院)共6間分院老年髖部骨折患者的資料(包括患者年齡、性別、骨折類型、住院時間、住院費用等)來分析老年骨質疏松性髖部骨折患者的基本流行病學特征、住院費用構成情況以及變化趨勢。方法:從廣東省中醫(yī)院和中山大學孫逸仙紀念醫(yī)院等6間分院病案信息管理系統(tǒng)獲得于1994年1月～2014年12月收治的骨質疏松性髖部骨折患者(股骨頸骨折或股骨粗隆間骨折)住院期間的病例資料,包括:患者住院號、姓名、性別、年齡、入院日期、出院日期、住院天數(shù)、臨床診斷、是否手術、住院總費用、床位費、西藥費、中藥費、檢查費、治療費、手術費、化驗費、輸血及輸氧費、護理費及其它費用等。結果:在過去21年,隨著我國社會老齡化及城鎮(zhèn)化的進展,髖部骨折的住院人數(shù)有了巨大的提升。本研究表明,患者平均年齡為(76.55±9.60,中位數(shù)78)歲,男性(75.47±9.93,中位數(shù)78)歲,女性(77.12±9.37,中位數(shù)77)歲,其中男女比例為1:1.92。髖部骨折的平均發(fā)病年齡由(73.57±8.55,中位數(shù)74)提升至(77.93± 10.29,中位數(shù)80)歲。平均住院天數(shù)為(22.59±12.28,中位數(shù)20)天,在不同骨折類型和性別之間未見統(tǒng)計學差異,住院天數(shù)也從1994年的(30.55± 16.34,中位數(shù)27)天減少至2014年的(16.09±7.34,中位數(shù)15)天。住院人數(shù)分布最多的年齡組是75～79歲組(21.29%),其次是80～84歲組(20.18%)、70～74歲組(15.7%)。在50～84歲之間的患者股骨頸骨折多于股骨轉子間骨折,而年齡≥85歲的患者卻少于股骨轉子間骨折。在85～89歲之間,兩種類型的骨折有著幾乎相同的發(fā)病率。平均的住院費用為(26619.17±20278.12,中位數(shù)23231.46)元,股骨頸骨折患者住院費用為(28579.74±21733.29,中位數(shù)25603.54)元,轉子間骨折患者住院費用為(24257.83±18096.40,中位數(shù)21711.52)元。住院費用每年以10.16%速度在增長,主要包括治療費(術中使用的材料和內植物費用,手術室的常規(guī)處置費)42.72%,藥物費24.27%,手術費13.07%,病房費4.44%,影像檢查費4.45%,檢驗費4.86%,護理費4.10%,輸血及輸氧費2.09%。結論:研究表明,隨著我國經濟的增長,老年骨質疏松性髖部骨折患者的住院費用不斷增多。其中,手術治療費、術中使用的器械費(內植物和材料)及藥物費占了主要部分。根據(jù)患者的具體情況,選擇合理的治療方案將有助于減少髖部骨折的住院費用。
[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 鹵9.60, median 78), male (75.47 鹵9.93) and female (77.12 鹵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 鹵8.55, median 74) to (77.93 鹵10.29, median 80) years. The average hospitalization days were (22.59 鹵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 鹵16.34) days in 1994 to (16.09 鹵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 鹵20278.12) yuan, (28579.74 鹵21733.29) yuan and (24257.83 鹵18096.40) yuan, respectively, and those of the patients with femoral neck fracture were (28579.74 鹵21733.29) yuan and (24257.83 鹵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.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R683;R197.323
，
本文編號：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 鹵9.60, median 78), male (75.47 鹵9.93) and female (77.12 鹵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 鹵8.55, median 74) to (77.93 鹵10.29, median 80) years. The average hospitalization days were (22.59 鹵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 鹵16.34) days in 1994 to (16.09 鹵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 鹵20278.12) yuan, (28579.74 鹵21733.29) yuan and (24257.83 鹵18096.40) yuan, respectively, and those of the patients with femoral neck fracture were (28579.74 鹵21733.29) yuan and (24257.83 鹵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.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R683;R197.323
，
本文編號：2405785
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