骨科与老年科共管模式下周末入院对老年髋部骨折患者住院总费用的影响研究  

Effects of weekend admission on total hospitalization expenses for elderly patients with hip fracture under the geriatric orthopedic co-management

作　　者：王立芳 吕艳伟 葛宇峰 潘蕾 段芳芳 朱仕文 Wang Lifang;Lyu Yanwei;Ge Yufeng;Pan Lei;Duan Fangfang;Zhu Shiwen(Clinical Epidemiology Research Center,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Department of Orthopaedics and Traumatology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Department of Medical Records and Statistics,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院临床流行病学研究室,北京100035 [2]首都医科大学附属北京积水潭医院创伤骨科,北京100035 [3]首都医科大学附属北京积水潭医院病案统计科,北京100035

出　　处：《中华创伤骨科杂志》2023年第12期1049-1055,共7页Chinese Journal of Orthopaedic Trauma

基　　金：北京市优秀人才基金(2018000021469G228);国家自然科学基金(82072445);北京积水潭医院院级科研基金(QN-201920)。

摘　　要：目的探讨骨科与老年科共管模式下周末入院对老年髋部骨折患者住院总费用的影响。方法回顾性分析2015年5月至2020年12月期间在北京积水潭医院住院且采用手术治疗的老年髋部骨折患者资料。根据患者入院日期不同分为两组:A组患者入院日期为星期一至星期四,B组患者入院日期为星期五至星期日。收集患者的一般人口学资料、诊断信息、合并症、住院总费用等资料,并通过秩和检验、χ^(2)检验、相关分析和多重线性回归等分析不同日期入院患者住院总费用、48 h内手术率、住院时间和院内病死率的差异。结果共纳入6075例老年髋部骨折患者,男1675例,女4400例;年龄80(74,85)岁。A组3935例患者,B组2140例患者。A组患者的住院总费用为58160.52(49215.45,72748.94)元,低于B组患者[58412.90(49163.58,72712.61)元],但差异无统计学意义(P>0.05)。A组患者48 h内手术率为75.8%(2984/3935),显著高于B组患者[49.3%(1054/2140)];住院时间为5(4,7)d,显著短于B组患者5(4,7)d,差异均有统计学意义(P<0.05)。两组患者院内病死率比较差异无统计学意义(P>0.05)。相关分析结果显示:住院时间、48 h内手术与住院总费用呈正相关(相关系数分别为0.379、0.159,P均<0.05)。多重线性回归分析结果显示:周末入院患者住院总费用更高,住院时间与住院总费用呈正相关,48 h内手术的患者住院总费用更低,差异均有统计学意义(P<0.05)。结论周末入院会增加老年髋部骨折患者住院总费用,延长患者住院时间,降低患者48 h内手术率。Objective To explore the impact of weekend hospitalization on total hospitalization expenses for elderly patients with hip fracture under the geriatric orthopedic co-management.Methods A retrospective analysis was conducted to analyze the clinical data of elderly patients with hip fracture who had been hospitalized for surgical treatment at Beijing Jishuitan Hospital from May 2015 to December 2020.They were divided into 2 groups based on their admission date.Group A was admitted from Monday to Thursday while Group B from Friday to Sunday.The general demographic data,diagnostic information,comorbidities,hospitalization expenses of the patients were collected.The differences in total hospitalization expenses,hospitalization time,rate of surgery within 48 hours and rate of hospital mortality between the 2 groups were analyzed by rank sum test,chi square test,correlation analysis,and multiple linear regression.Results A total of 6,075 patients with hip fracture were included in this study,including 1,675 males and 4,400 females with a median age of 80(74,85)years.There were 3,935 ones in group A and 2,140 ones in group B.The total hospitalization expenses for group A was 58,160.52(49,215.45,72,748.94)yuan,insignificantly lower than those for Group B[58,412.90(49,163.58,72,712.61)yuan](P>0.05).The rate of surgery within 48 hours for group A was 75.8%(2,984/3,935),significantly higher than that for group B[49.3%(1,054/2,140)].The hospitalization time for group A was 5(4,7)days,significantly less than that for group B[5(4,7)days](P<0.05).There was no significant difference in the rate of hospital mortality between the 2 groups(P>0.05).Multiple linear regression analysis showed that total hospitalization expenses were significantly higher for patients admitted on weekends,hospitalization time was positively correlated with total hospitalization expenses,and total hospitalization expenses were significantly lower for the patients undergoing surgery within 48 hours(P<0.05).Conclusion Admission on weekends can increase tota

关 键 词：髋骨折 住院时间 住院总费用 周末入院 老年人 

分 类 号：R197.3[医药卫生—卫生事业管理]