骨质疏松性髋部骨折的直接经济负担及其影响因素分析

Study on direct economic-burden and its risk factors of osteoporotic hip fracture

目的分析骨质疏松性髋部骨折患者的直接经济负担及其影响因素。方法对北京协和医院1998年1月至2002年12月骨质疏松性髋部骨折出院患者采用回顾性问卷调查方式进行直接经济负担数据采集,并对影响因素进行单因素方差分析及多因素logistic回归分析。结果平均每例髋部骨折患者直接经济负担为32 776元/年,影响直接经济负担总费用的因素有住院时间、结局、患者工作状态;住院期间费用影响因素有住院时间、患者骨折类型及患者工作状态;影响患者康复期费用的因素有患者住院及康复时间、结局。年龄、治疗方式及医疗负担方式对费用无显著性影响。结论骨质疏松性髋部骨折直接经济负担重,强调从经济学角度论证重视骨质疏松防治的重要性。

Objective To investigate the net “per case” direct economic burden of osteoporotic hip fracture of in-patients at Peking Union Medical College Hospital （PUMCH）, and to explore the related factors which will influence the burden of the disease. Methods Data was from a retrospective questionnaire on 90 osteoporotic hip fracture in-patients of PUMCH above 50 years old from 1998 to 2002. The direct cost of fracture consisted of inpatient care, outpatient care, home care, appliance, and nutrition etc. Multiple statistics method was used to analyze the factors affecting the direct costs of disease. Results The average age of the studied population was 71.78± 9.7 years, including 29 males and 61 females. Yearly direct economic burden for one patient of osteoporotic hip fracture was 32 776 RMB, in which hospitalization expense was 23 107 RMB, accounting for 70.5%. Factors which influencing total direct costs would include： length of hospitalization, occupation and the outcome of disease, while types of hip fracture,occupation and the length of hospitalization affecting the cost during hospitalization. The outcome of disease, length of hospitalization and rehabilitation influenced the cost during convalescence while age, type of payment and treatment, did not show significant influence on the cost of hip fracture. Conclusion Osteoporosis had become a serious public health problem among the elderly, bringing about the increase of economic burden all over the world both on social healthcare and families of the patients. Our data provided base for preventive health care or health insurance on osteoporosis.