老年骨质疏松性椎体压缩骨折患者住院费用影响因素分析

Analysis of Factors Influencing Hospitalization Costs in Elderly Patients with Osteoporotic Vertebral Compression Fractures

目的研究老年骨质疏松性椎体压缩骨折患者住院费用结构及其影响因素,为合理控制医疗费用、减轻患者经济负担提供参考。方法收集某院2022年1月1日-2022年12月31日骨科出院的423例老年骨质疏松性椎体压缩骨折患者病例资料,包括基本信息、骨折部位、是否手术、临床路径管理及住院费用。利用非参数检验和多元线性回归分析对住院费用及其影响因素进行分析。结果老年骨质疏松性椎体压缩骨折患者男女性别比例为1:3.7,平均年龄为74.35岁,平均住院天数为5.31±3.00天,平均住院费用为32231.96±10260.97元,住院费用中位数为33221.99(29716.40~37106.51)元,其中材料费占比最高(66.06%),其次为药品费(15.04%)。多元线性回归分析结果显示F=108.432,P<0.001,R2=0.560。影响住院费用的因素依次为是否手术、住院天数、有无基础疾病、临床路径管理。结论老年骨质疏松性椎体压缩骨折患者住院费用的主要构成部分为材料费、药品费,主要影响因素为是否手术、住院天数。严格把握手术适应证以及控制住院天数,可以有效降低患者的住院费用,减轻患者经济负担。

Objectives This study aims to analyze the hospitalization cost structure and influencing factors of elderly patients with osteoporotic vertebral compression fractures,so as to provide a reference for reasonably controlling medical expenses and reducing financial burden of patients.Methods The data of 423 elderly patients with osteoporotic vertebral compression fractures were collected from a hospital between January 1st and December 31st,2022.This included basic information,fracture site,surgical intervention,clinical pathway management,and hospitalization costs.The influencing factors of hospitalization expenses were analyzed by non-parametric test and multiple linear regression.Results The male to female gender ratio of elderly patients with osteoporotic vertebral compression fractures was 1:3.7.The average age was 74.35 years.The average length of hospital stay was 5.31±3.00 days,with an average hospitalization cost of 32,231.96±10,260.97 yuan.The median hospitalization cost was 33,221.99 yuan(range:29,716.40 to 37,106.51 yuan).The proportion of materials expenses was the highest(66.06%),followed by the cost of drugs(15.04%).The multivariate analysis showed that F=108.432,P<0.001,R2=0.560.The factors that affect hospitalization expenses were,in order,whether surgery is performed,length of hospitalization,the presence of underlying diseases,and clinical path management.Conclusions The main components of hospitalization expenses for elderly patients with osteoporotic vertebral compression fractures are material fees and drug fees.The main influencing factors are whether surgery is performed and the length of hospitalization.The patients'hospitalization costs can be effectively reduced and their economic burden can be alleviated by strictly adhering to surgical indications and managing hospitalization duration.