绝经后女性骨质疏松患者骨折发生情况及相关医疗费用研究

The incidence of fractures and related medical costs in female patients with postmenopausal osteoporosis

目的了解天津市新诊断绝经后女性骨质疏松(PMO)患者骨折发生情况及相关医疗费用,为骨质疏松(OP)及骨折的防治提供科学依据。方法基于2011—2017年天津市城镇职工基本医疗保险参保人随机抽样数据库,选取2013—2015年新诊断的PMO患者为研究对象。分析患者在2年随访期内的骨折发生及就诊情况、骨折的次均住院和门诊费用及费用结构情况。采用Stata 13.1软件进行描述性统计分析。结果该研究最终纳入患者40 025人,平均年龄为(62.5±9.1)岁。在2年随访期内,共有2 931例患者(7.3%)发生了3 199次骨折,椎体、髋部和臂部是骨折最常见的发生部位,发生例数分别占总骨折例数的29.4%、28.9%和12.3%。85.8%的髋部骨折和71.7%的下肢骨折患者接受住院治疗,而75.2%的椎体骨折和90.6%的肋骨骨折患者选择门诊就诊。骨折的平均住院费用为7 064.3元/次,门诊费用为341.7元/次。其中髋部骨折住院费用最高,为8 348.7元/次;臂部骨折门诊费用最低,为183.1元/次。结论天津市PMO患者发生椎体、髋部和臂部骨折的比例较高,髋部骨折患者的住院经济负担最为严重。应加强对绝经后女性的宣传教育,防范PMO及骨质疏松性骨折的发生。

Objective To understand the incidence of fractures and related medical costs in newly diagnosed female patients with postmenopausal osteoporosis(PMO) in Tianjin,and to provide the scientific basis for the prevention and treatment of osteoporosis(OP) and fracture.Methods Based on the data of Tianjin Urban Employee Basic Medical Insurance(from 2011 to 2017),newly diagnosed PMO patients from 2013 to 2015 were selected as the subjects.The incidence and medical utilization of fractures and the costs per hospitalization and per outpatient visit during the two-year follow-up period were analyzed.Stata 13.1 software was used for descriptive statistical analysis.Results In the study 40 025 patients(average age was 62.5±9.1 years old) were included.During the two-year follow-up period,2 931 cases(7.3%) of the total patients had 3 199 fractures.Vertebral,hip and arm were the most common fracture sites(29.4%,28.9% and 12.3%,respectively);85.8% of the patients with hip fractures and 71.7% of the patients with lower extremity fractures received inpatient treatment,while 75.2% of the patients with vertebral fractures and90.6% of patients with rib fractures received outpatient treatment.The average cost per hospitalization was 7 064.3 Yuan,among which the hip fracture cost was the highest(8 348.7 Yuan).The average cost per outpatient visit was 341.7 Yuan,among which the arm fracture cost was the lowest(183.1 Yuan).Conclusion The incidences of vertebral,hip and arm fractures are relatively high.Hospitalization imposed a heavy economic burden on the patients with hip fracture.Government should enhance the propaganda and education to prevent PMO and osteoporosis fractures.