股骨粗隆间骨折患者住院费用影响因素分析

摘要

目的：调查研究股骨粗隆间骨折患者住院费用影响因素。方法采用回顾性调查的方法，研究155名股骨粗隆间骨折患者住院费用，其中人工关节置换术组20例，内固定术组患者135例。对两组患者年龄及整体健康状况进行同质性检验，差异无统计学意义（P >0.05）。利用多元线性回归及描述性分析的方法对各影响因素进行综合分析。结果住院费用的影响因素有住院天数、手术方式、伴随疾病、受伤至手术时间、手术材料等；两组患者各项费用中材料费差异有统计学意义（P <0.01）。在只考虑出院临床结局的情况下，实施内固定术的成本较小。结论规范诊疗流程，缩短住院日，掌控招标环节，减少中间购买环节，降低内植物材料费用是减轻患者经济负担，节约医疗资源的有效途径。%Objective To investigate the factors affecting the hospitalization costs of the patients with intertrochanteric fe-mur fractures. Methods Using a retrospective survey method we explored hospital expenses and comprehensively analyzed va-rious factors of 155 patients with multiple linear regression method and descriptive analysis. The arthroplasty group has 20 peo-ple and the internal fixation group has 135 people. Contrast basic data of the patients between internal fixation and arthroplasty using chi-square test and t-test(P > 0. 05)Results Factors of hospitalization costs were number of days in hospital,surgery, complications,time of injury to surgery,implant material and so on. And in the composition of the total hospital charges,there ass a statistical difference in implant material parts between two groups of patients(P < 0. 01). The cost of internal fixation was smaller than arthroplasty in considering only clinical outcomes. Conclusion Regulation of the procedure of diagnosis and treatment,shorten the hospital days;control of bidding link,reduction of intermediate links of buy and reduce implant material costs are effective ways to the economic burden on patients and save medical resources.