中老年骨质疏松性髋部骨折患者住院费用影响因素分析  

Analysis of Influencing Factors of Hospitalization Costs of Middle Aged and Elderly Patients with Hip Osteoporotic Fracture

作　　者：马楠 袁蕊 赵凯平 Ma Nan;Yuan Rui;Zhao Kaiping(Department of Medical Record Management and Statisitics,Beijing Jishuitan Hospital Medical University,Beijing 100035,China;不详)

机构地区：[1]首都医科大学附属北京积水潭医院病案统计科,北京市100035

出　　处：《中国病案》2024年第12期63-67,共5页Chinese Medical Record

基　　金：首都医科大学附属北京积水潭医院“学科骨干”计划专项(XKGG202207)。

摘　　要：目的分析中老年骨质疏松性髋部骨折患者住院费用的主要影响因素,为合理控制住院费用提供参考依据。方法通过检索主要诊断ICD编码及损伤原因,收集某院2019年1月1日-2023年12月31日期间住院的50岁以上骨质疏松性髋部骨折患者,共计9444例患者的住院病案信息,采用多重线性回归分析方法分析影响住院费用的因素。结果9444例患者住院信息中,每例平均住院费用为47082.70元,例均住院费用从2019年的51314.64元降至2023年的36207.52元,整体呈负向增长,平均增长速度为-8.35%;多重线性回归分析:年龄、职业类型、付费方式、住院天数、治疗方式、入院自理能力评分、重症监护使用情况和耗占比是住院费用的影响因素,P<0.05。根据标化后回归系数比较,主要影响因素依次是耗占比、住院天数和重症监护使用。结论高年龄组、农民群体、支付方式为自费、住院天数增加、接受手术治疗、入院自理能力评分越低、使用重症监护治疗以及耗占比越高均会不同程度增加住院费用。通过对高危人群开展健康宣教、合理控制住院天数,以及选择国家集采耗材等措施,可对控制患者住院费用具有一定的积极作用。Objectives To analyze the main influencing factors of hospitalization costs in middle aged and elderly patients with hip osteoporotic fracture,and provide reference for reasonable control of hospitalization costs.Methods The inpatient records of 9444 patients over 50 years of age with osteoporotic hip fracture from January 1st,2019 to December 31st,2023 were collected by retrieving primary diagnostic ICD codes and cause of injury.Multiple linear regression analysis was used to investigate the factors affecting hospitalization costs.Results A total of 9444 inpatient cases were collected,the average hospitalization costs from 2019 to 2023 was 47082.70 yuan,and the average hospitalization costs decreased from 51314.64 yuan in 2019 to 36207.52 yuan in 2023,showing an overall negative growth(average speed of growth was-8.35%).Multiple linear regression analysis showed that age,occupation type,payment method,length of stay,treatment method,self-care ability score at admission,use of intensive care,and material cost proportion were the influencing factors of hospitalization costs(P<0.05).According to the comparison of standardized regression coefficients,the main influencing factors were the material cost proportion,the length of stay and the use of intensive care.Conclusions Older age group,peasant group,self-paid payment method,increased length of stay,surgical treatment,lower self-care ability score at admission,used ICU,and higher material cost proportion would increase the hospitalization costs to different degrees.Health education for high-risk groups,reasonable control of length of stay,and selection of national collection of consumables had a positive effect on the control of hospitalization costs.

关 键 词：骨质疏松 髋部骨折 住院费用 影响因素 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学] R197.3[医药卫生—临床医学]