Objective To analyze the hospitalized prevalence in the past 5 years (2003 -2007) and to estimate resource utilization associated with osteoporotic vertebral fractures , including hospital length of stay and inpatient costs in Guangzhou, China. Methods The data of 1 808 patients aged 50 years and older, who were hospitalized for primary diagnosis of vertebral fractures in four hospitals in the past 5 years, were reviewed. Clinical parameters such as sex , hospital length of stay, inpatient costs, and the constitutions of the inpatient costs were analyzed . Results Over the 5 - year study, the number of hospitalizations for vertebral fractures was kept at the same level . The male to female ratio was about 1:2.35. Average age was (72.08±9.92) years old. Average hospital length of stay was (20. 12 ±13. 92) days with no significant difference among genders , the different years, and the different diagnoses. The patients with age of 70 to 79 years accounted for the majority of the hospitalization (41. 87% ). Between the age of 50 to 79 years the lumbar vertebral fracture was significantly more prevalent than thoracic fracture (P <0. 01) ; however, there was no significant difference in patients over 80 years old (P>0.05). The inpatient cost was (13. 49 ± 17. 42 ) thousand Yuan (RMB) per patient, with no significant difference between the thoracic and lumbar vertebrae fractures (P > 0.05 ). The inpatient cost for operative patient was (33. 03 ± 28. 26 ) thousand Yuan ( RMB) per patient, and non - operative was ( 81. 48 ± 59. 69 ) thousand Yuan (RMB) per patient. The inpatient cost included 43. 24% of treatment costs (including implants, materials used in the theatre and routinely care of the wound ) , 31. 33% of pharmacy intervention , 2. 89% of operation, 8. 16% of ward expenditure, 5.5% of physical investigation, and 4.75% of chemistry tests. The inpatient cost was negatively correlated with the age. The total inpatient cost was increased every year in the past 5 years by 23. 97% , and by 18. 93% in operative patient, while by 9. 51% in non -operative ones. Conclusion The growing economic impact is aroused from the in-patient treatment of osteoporotic spine fractures , most of which is correlated to treatment cost and pharmacy intervention . More attention should be paid to the vertebral fracture of menopausal women due to the large population . National datasets need to be further refined to ensure more accurate estimations of the cost of vertebral fractures in the China .%目的 回顾分析2003年1月至2007年12月5年广州地区老年脊柱骨折住院患者的基本情况与住院费用结构,了解老年骨折住院患者基本趋势及其所需要的医疗资源.方法 5年间,广州中医药大学第一、二附属医院、中山大学附属第二医院与广州医学院第三附属医院骨科共收治1 808例年龄≥50岁的脊柱骨折患者,其基本情况来源于医院病案信息管理系统.回顾分析患者的年龄结构、性别构成、住院时间与住院费用等.结果 过去5年脊柱骨折的患者住院人数相对稳定,每年的女性患者人数均显著高于男性患者.男女患者总人数比为1:2.35,男性占29.87%,女性占70.13%.患者最大年龄为105岁,平均(72.08±9.92)岁.平均住院时间(20.12±13.92)d,各个年龄段住院时间差异无统计学意义(P＞0.05).各个年龄段中,70～79岁年龄段的患者数最多(41.87%).胸椎与腰椎骨折老年患者50～79岁年龄段随着年龄的增加患者而增加,80～岁以上随着年龄的增加而减少,胸腰椎骨折的比例为1:1.38.患者的住院总费用平均为6 532.14(443.02,10 637.60)万元,胸腰椎骨折的住院费用比较差异无统计学意义(P＞0.05),手术患者住院总费用为(3.30±2.83)万元,非手术患者(0.82±0.60)万元.住院总费用中,治疗费(含内置物等费用)占43.24%,药费占31.33%,其次为床位费8.16%,检查费5.5%,化验费4.75%,手术费2.89%.以50～59岁年龄段患者住院费用最高,并与年龄段的趋势相反.近5年来总住院费用逐年递增,平均每年增加23.97%,手术患者年增长率为18.93%,非手术患者年增长率为9.51%.结论 脊柱骨折所需医疗费用逐年递增.女性患者占全部患者的2/3以上,而且60～69岁女性患者比例最高,绝经后骨质疏松及其骨折是防治工作的重点.有效控制内置物以及药费是减少脊柱骨折占用医疗资源,减轻患者与社会经济负担的有效途径.
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