社区老年人跌倒的流行病学特征及医疗负担分析

Analysis on epidemiological characteristics and medical burden of falls among older people in community

目的了解社区老年人跌倒的流行病学特征及医疗负担。方法采取随机抽样的方法对石家庄市两个社区的1609名60岁及以上老年人过去一年跌倒发生情况进行回顾性调查。结果 180人发生跌倒,年跌倒发生率为11.2%。女性(12.5%)高于男性(9.1%)(χ2=4.618,P=0.032<0.05)。跌倒282人次,人次跌倒发生率为17.5%。跌倒发生在家中占48.0%,家外小区内占25.6%,小区以外占38.8%;跌倒自身原因,以运动中没有保持平衡(22.9%)和注意力不集中(22.1%)为主。跌倒环境因素中,24.0%没有保护措施,18.0%地面不平,12.0%路滑,10.8%物品挡路。跌伤率36.5%。跌倒后4.8%住院,8.2%到门诊急诊处理;住院天数中位数为23 d,在家卧床天数中位数为30 d。受伤中骨折最多,占43.4%。跌伤后12.7%活动能力明显下降。跌倒后的医疗花费中位数为510元。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。

Objective To study the epidemiological characteristics and medical burden of fails among the elderly people in communities. Methods Retrospective investigation was carried out among 1609 elders＇age over than 60 years who were selected by random sampling from 2 communities in Shijiazhuang city. Results There were 180 failer cases, accounting for 11.2% of the participants. Higher proposition was observed among female （12.5% ） than male （9.1% ） （X2 = 4.618, P =0.032 〈0.05） . The total failing times were 282, which made the fall incidence occupy 17.5% of the subjects. Among the fallers, fell at home account for 48.0%, outside home within the community account for 25.6%, outside communities account for 38.8% ; as for the fallers intrinsic reasons, no maintaining balance （22.9% ） and inattention （22. 1% ） during exercise became the mainly aspects; as for environmental reasons, 24.0% had no protective measures, 18.0% fell for uneven ground, slippery pavement accounted for 12.0%, and 10.8% for things blocked the path. 36.5% of harm rate. 4.8% of the 180 fallers were hospitalized and 8.2% accepted outpatient emergency treatment. The media length of hospital stay of fails was 23 days, and median days staying in bed were 30 days. Among the injured people, the most common was bone fracture which accounted for 43.4%. After injury, 12.7% of them experience a significantly reduced capacity to perform physical activities. The median medical cost of falls was 510 RMB. Conclusions Fail among older adults in community has relatively impact on their health, will cause a certain of medical burdens.