骨质疏松性骨折手术患者住院费用统计分析

Statistical analysis on hospitalization expenses of patients with osteoporotic fracture undergoing surgery

背景:随着人口老龄化、手术技术及理念的更新、人们对生活质量要求的不断提升,因骨质疏松性骨折行手术治疗的患者不断增加,骨质疏松性骨折给患者及其家庭,甚至整个社会都带来了沉重的经济负担。目的:分析骨质疏松性骨折手术患者住院费用组成及其相关影响因素,为后续研究或医疗政策制定提供相关依据。方法:回顾性分析2018年9月至2019年8月收治的骨质疏松性骨折手术患者233例次。从病历系统提取相关信息并进行统计学分析,包括性别、年龄、身高、体重、术前血红蛋白及白蛋白水平、相关基础病、骨折部位、手术及麻醉方式、重症监护室天数、并发症和住院费用等方面。住院费用主要包含检查费、化验费、手术费、药费和材料费。结果:研究共纳入233例次骨质疏松性骨折患者,其中椎体压缩骨折138例,股骨颈骨折43例,股骨转子间骨折25例,桡骨远端骨折18例,肱骨近端骨折9例。233例次的住院总费用为15,119,297元,平均住院天数为(6.6±7.9)d,平均住院费用为(64,890±38,250)元。统计学分析结果显示,骨折部位数、手术方式、住院天数、术后转重症监护病房及术后出现并发症是影响患者住院费用的主要因素。结论:本研究更新了骨质疏松性骨折住院费用等相关资料,并提出了影响患者住院费用的主要因素,对后续研究具有一定的参考性。

Background: With the aging of the population, updating of surgical techniques and concepts, and improving of life quality, more and more patients require surgical treatment for osteoporotic fractures. Osteoporotic fractures bring heavy economic burden to patients, their families and whole society. Objective: To analyze the hospitalization expenses and its influencing factors in patients with osteoporotic fractures taking surgical treatment in the past year and provide evidence for follow-up researches or medical policy formulation. Methods: A retrospective analysis of 233 cases of osteoporotic fractures with surgical treatment discharged from September 2018 to August 2019 was conducted. Relevant information was extracted from the medical record system and analyzed by SPSS, including gender, age, height, weight, preoperative hemoglobin and albumin, chronic diseases, fracture sites, surgical and anesthesia methods, intensive care unit days, complications and hospitalization costs consisting of examination fee, laboratory fee, operation fee, medicine fee and materials expense. Results: The total hospitalization cost was 15,119,297 yuan, including 138 cases of vertebral compression fractures, 43 cases of femoral neck fractures, 25 cases of intertrochanteric fractures, 18 cases of distal radius fractures, and 9 cases of proximal humerus fractures. The average length of hospital stay was(6.6±7.9) days, and the average expense was(64,890±38,250) yuan. Among various factors affecting the hospitalization expenses, the number of fracture sites, surgical methods, length of hospital stay, postoperative transference to the intensive care unit and postoperative complications were the main factors. Conclusions: This study updates the data on the hospitalization expenses for osteoporotic fractures with surgical treatments, and proposes the main factors affecting the hospitalization expenses of patients, which provides certain reference for follow-up researches.